Professional Documents
Culture Documents
LEARNING OUTCOMES
(Batch 29 Onwards)
CONTENTS
page
1.
DEPARTMENT OF ORTHOPAEDICS......4
1.1 Overall Learning Outcomes....5
1.2 Lecture Topics (Semester 6 & 7) ...7
1.3 Clinical Teaching (Semester 6 & 7). 43
1.4 Tutorial (Semester 6 & 7)..45
1.5 Problem Based Learning........56
1.6 Small Group Teaching...64
1.7 Self Directed Learning...69
1.8 Clinical Teaching (Semester 10).... 71
2.
DEPARTMENT OF PAEDIATRICS....108
3.1 Overall Learning Outcomes .109
3.2 Lecture Topics (Semester 6 & 7)......110
3.3 Problem based Learning ..119
3.3 Clinical Teaching (Semester 6 & 7). 122
3.3 Clinical Teaching (Semester 8 & 9).... 122
3.4 Senior Clerkship (Semester 10)... 123
4.
DEPARTMENT OF ENT.......124
4.1 Overall Learning Outcomes .125
4.2 Lecture Topics (Semester 6 & 7)......126
4.3 Clinical Teaching (Semester 8 & 9). 141
4.4 Problem Based Learning.......143
5.
DEPARTMENT OF SURGERY....145
5.1 Overall Learning Outcomes .146
5.2 Learning Outcomes for Semester 6 & 7.......147
5.3 Learning Outcomes for Lecture Topics Semester 6 & 7..........148
5.4 Learning Outcomes for PBL Semester 6& 7159
5.5 Learning Outcomes for Skills Lab & SDL Semester 6 & 7.160
5.6 4 Learning Outcomes for Clinical Teaching Semester 6 & 7..162
5.7 Learning Outcomes (Semester 8 & 9)..164
5.8 Clinical Learning Outcomes (Semester 10).....165
6.
DEPARTMENT OF PSYCHIATRY......217
7.1 Lecture Topics (Semester 6, 7).........218
7.2 Clinical Teaching (Semester 6,7).....224
7.3 Clinical Teaching (Semester 8, 9)........225
7.4 Clinical Teaching (Semester 10).......226
8.
DEPARTMENT OF MEDICINE........229
8.1 Overall Learning Outcomes..230
8.2 Lecture Topics (Semester 6, 7).....234
8.3 Clinical Teaching (Semester 6 & 7).........266
8.4 Clinical Teaching (Semester 8 & 9).276
8.5 Problem Based Learning..287
8.6 e-Learning ...298
8.7 Senior Clerkship. .....299
9.
DEPARTMENT OF OPTHALMOLOGY......305
9.1 Overall Learning Outcomes..308
9.2 Lecture Topics (Semester 6 & 7) .........306
9.3 Clinical Teaching (Semester 6 & 7). 317
9.4 Problem Based Learning ......319
9.5 Operation Theatre learning Outcomes.321
10.
11.
PATIENT SAFETY..........327
11.1 Learning Outcomes....328
Learning Outcomes
sound
knowledge
immediate
Skills
At the end of the course, the student shall be able to:
o Apply clinical skills (history taking, clinical examination) to diagnose common
Orthopaedic conditions
o Provide for immediate care (first aid) in acute conditions and be able to manage
simple conditions like sprains, strains and uncomplicated fractures.
o Shall know the principles in application of plaster and tractions and be able to
splint fractures appropriately, manage common bone infections, and know the
indications for amputations and corrective measures for bone deformities.
o Advise appropriate aspects of rehabilitation wherever necessary.
o View the patient as a whole and advise appropriate treatment/referrals.
Attitudes
At the end of the course, the student shall:
o Have the right attitude and commitment to deliver the best possible care for
his/her patients.
o View the patient with a holistic approach.
-------------------------------------------------------------- ----------------------------------------------
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (3 Hours)
: Lecture hall
1. AIM / GOAL
Understanding the basics of a fracture, types / classification, mechanism of injury,
clinical features, principles in its union and management and complications of
fractures.
2. LEARNING OBJECTIVES
Should be able to identify or suspect a fracture and its type with the clinical history
and be able to initiate its management with the understanding of the basic principles.
3. CONTENTS
Definition of fracture, mechanism of injury, classification and types, healing of a
fracture, principles in its management, complications of fracture
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the definition, mechanism of injury and cause of stress and
pathological fractures. Understanding the definition, causes, clinical features and after
effects of compartmental syndrome as a complication of fractures
2. LEARNING OBJECTIVES
Be able to identify or suspect a pathological fracture or stress fracture in a patient
Have an understanding of compartmental syndrome and identify it early.
3. CONTENTS
Definition of stress and pathological fractures, causes for these fractures,
investigations and management. Definition, causes, cardinal clinical features, effects
on tissues, investigations and management of compartmental syndrome. After effects
of compartmental syndrome : Ischemic contractures, types and principles in
management.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a) Apleys System of Orthopaedics and Fractures
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the basics of open fractures, its definition, classification and principles
in management.
2. LEARNING OBJECTIVES
Be able to identify or suspect an open fracture in a patient and initiate care and
treatment with the understanding of the principles in its management
3. CONTENTS
Definition, classification, initial care of the wound, investigations of importance,
procedure in debridement of wounds and methods in stabilization of bone, after care
of the wound and complications of open fractures.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (2 Hours)
: Lecture hall
1. AIM / GOAL
Understanding the basics of clavicular fractures, displacements at the site,
investigations and principles in its management.
Gain knowledge on the definition, types, mechanism of injury, clinical features,
investigation and principles in the management of acute and chronic anterior
dislocation of shoulder
2. LEARNING OBJECTIVES
Be able to identify or suspect clavicular fracture and acute and chronic anterior
dislocation of the shoulder in a patient and initiate care and treatment with the
understanding of the principles in its management
3. CONTENTS
Relevant anatomy, mechanism of injury, clinical features, investigations,
complications and principles in management of clavicular fractures
Definition of dislocation, relevant anatomy, types, mechanism of injury, cardinal
clinical features, investigations, methods of reduction, and after care. Complications
of acute dislocation and causes and principles in management of chronic dislocation
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a) Apleys System of Orthopaedics and Fractures
b) Book of Orthopaedics and Traumatology: M Natarajan & Mayilvahanan Natarajan
10
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
(a) Understanding the displacements at the site, causes for displacement,
investigations and principles in its management and complications of the fracture
(b) Definition, types, mechanism of injury, clinical features, investigation and
principles in the management acute and complications of supracondylar fracture
2. LEARNING OBJECTIVES
Be able to identify fractures of the shaft and supracondylar fractures of the humerus
in a patient and initiate care and treatment with the understanding of the principles in
its management
3. CONTENTS
Relevant anatomy, mechanism of injury, clinical features, investigations,
complications and principles in management of fractures of the shaft of the humerus
Definition of supracondylar fractures, relevant anatomy, types, mechanism of injury,
cardinal clinical features, investigations, methods of fixation, complications and
principles in management.
4. TEACHING METHODS: Didactic lecture
11
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the concepts in fracture in a two bone situation, special types of
fracture- dislocations, investigations and principles in its management.
Gain knowledge on the definition, types, mechanism of injury, clinical features,
investigation and principles in the management of fractures around the wrist and hand
2. LEARNING OBJECTIVES
Be able to identify or suspect fracture both bones of the forearm or other fractures and
fracture dislocations therein and those around the wrist and be able to investigate
them and initiate or plan management.
3. CONTENTS
Relevant anatomy, mechanism of injury, clinical features, investigations,
complications and principles in management of both bones of the forearm, Monteggia
and Galeazzi fracture-dislocation.
Definition , relevant anatomy, types, mechanism of injury, cardinal clinical features,
investigations and treatment and complication of Colles, Smiths and Bartons
fracture, scaphoid fracture and Bennet fracture dislocation.
12
REFERENCES
Apleys System of Orthopaedics and Fractures
Book of Orthopaedics and Traumatology: M Natarajan & Mayilvahanan Natarajan
Essential Orthopaedics : J. Maheshwari
Clinical Oriented Anatomy: Keith Moore and Arthur Dalley
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the basics of vertebral fractures and dislocation and associated spinal
cord injuries and the principles in its management.
2. LEARNING OBJECTIVES
Be able to identify or suspect vertebral fractures and dislocations in a patient and
initiate care and treatment with the understanding of the principles in its management
3. CONTENTS
Relevant anatomy, mechanism of injury, classifications, clinical features,
investigations, complications and principles in management of vertebral injuries and
spinal cord damage and complications thereof.
4. TEACHING METHODS: Didactic lecture
13
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the basics of pelvic, sacral and acetabular fractures, investigations and
principles in its management.
2. LEARNING OBJECTIVES
3.
Be able to identify or suspect pelvic fractures and sacral and acetabular injuries in a
patient and initiate care and treatment with the understanding of the principles in its
management
3. CONTENTS
14
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the basics of fractures of the neck of the femur and inter trochantric
fractures, displacements at the site, investigations and principles in its management
and complications of this fracture.
2. LEARNING OBJECTIVES
Be able to identify or suspect fractures of the neck of the femur and inter trochantric
fractures in a patient and initiate care and treatment with the understanding of the
principles in its management and complications
15
3. CONTENTS
Relevant anatomy, mechanism of injury, clinical features, classification,
investigations, complications and principles in management of fractures of the neck
of the femur and inter trochantric fractures and their complications.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the basics of hip dislocations, types, and principles in its identification
and management as also that of fractures of the shaft of the femur, the displacements
at the site, investigations and principles in its management.
2. LEARNING OBJECTIVES
16
Be able to identify or suspect dislocation of the hip and fractures of the shaft of the
femur in a patient and initiate care and treatment with the understanding of the
principles in its management.
3. CONTENTS
Relevant anatomy, classification, mechanism of injury, clinical features,
investigations, complications and principles in management of dislocations of the hip
Fractures of the shaft of the femur: relevant anatomy, types, mechanism of injury,
clinical features, investigations and principles in management.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the basics of common ligament injuries around the knee and the
meniscus, the methods in clinical and other investigations and principles in its
management.
17
2. LEARNING OBJECTIVES
Be able to identify or suspect injuries to the ligaments in and around the knee in a
patient and initiate care and treatment with the understanding of the principles in its
management
3. CONTENTS
Relevant anatomy, mechanism of injury, clinical features and tests, investigations,
complications and principles in management of injuries to the ligaments in and
around the knee and the meniscus.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
18
Understanding the basics of fractures of the patella, its clinical features, investigations
and principles in its management.
Gain knowledge on basics of fracture of the tibia and fibula at different levels, types,
mechanism of injury, clinical features, investigation and principles in the
management
2. LEARNING OBJECTIVES
Be able to identify or suspect patella, tibia and fibula fractures in a patient and initiate
care and treatment with the understanding of the principles in its management
3. CONTENTS
Relevant anatomy, classification, mechanism of injury, clinical features,
investigations, complications and principles in management of fractures of the patella,
tibia and fibula and complications thereof.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (2 Hours)
: Lecture hall
19
1. AIM / GOAL
Understanding the basics of injuries to the ankle, types of injuries, investigations and
principles in its management.Gain knowledge on some fractures and fracturedislocations of the foot ( Talar fractures, Lisfrancs and Choparts fracture
dislocations, Jones fracture, March fracture), mechanism of injury, clinical features,
investigation and principles in the management.
2. LEARNING OBJECTIVES
Be able to identify or suspect ligament and bony in juries around the ankle as also
fractures and fracture-dislocations in the foot in a patient and initiate care and
treatment with the understanding of the principles in its management
3. CONTENTS
Relevant anatomy, classification,mechanism of injury, clinical features,
investigations, complications and principles in management of injuries around the
ankle and foot.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
20
VENUE
: Lecture hall
1. AIM / GOAL
Understanding the basics of injuries to nerves, investigations modalities and
principles in its management.
Gain knowledge on tendon injuries in general and principles in its management
2. LEARNING OBJECTIVES
Be able to identify or suspect injuries to nerves in a patient and initiate care and
treatment with the understanding of the principles in its management
3. CONTENTS
Relevant anatomy of the structure of a nerve, types of nerves, classification, clinical
features in general, investigations, complications and principles in management of
nerve injuries.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
21
DURATION: (1 hour)
: Lecture hall
1. AIM / GOAL
Understanding the etiology, deformities, types, pathology, clinical features,
investigations and principles in management of congenital talipes equino varus.
2. LEARNING OBJECTIVES
Be able to identify or suspect CTEV in a child and initiate care and treatment with the
understanding of the principles in its management
3. CONTENTS
Definition, etiology, deformities, types, pathology, clinical features, investigations
and principles in management of congenital talipes equino varus in different age
groups.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
22
TOPIC
DURATION: (1 hour)
: Lecture hall
1. AIM / GOAL
Understanding the incidence, etiology, pathology, clinical features and tests,
investigations and principles in management of developmental dysplasia of the hip.
2. LEARNING OBJECTIVES
Be able to identify or suspect DDH in a child and initiate care and treatment with the
understanding of the principles in its management
3. CONTENTS
Definition, etiology, pathology, clinical features and tests in identification,
investigations and principles in management of developmental dysplasia of the hip in
different age groups.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
23
TOPIC
: Lecture hall
1. AIM / GOAL
Understanding the etiology, types, pathology, clinical features, investigations and
principles in management of rickets and osteomalacia.
2. LEARNING OBJECTIVES
Be able to identify or suspect this condition in a child and initiate care and treatment
with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, deformities, types, pathology, clinical features, investigations
and principles in management of rickets and osteomalacia
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
24
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Introduction to various radiological investigative modalities available and used in
Orthopaedic practice.
2. LEARNING OBJECTIVES
Be able to think of the appropriate investigative radiological tool that may help
diagnose or confirm diagnosis in a given patient.
3. CONTENTS
Aspects of Orthopaedic radiology, the method in reading an X-ray to help diagnose
Orthopaedic conditions. Understanding types of bony lesions commonly seen.
Introduction to additional methods like CT scan, MRI, myelogram, sinogram,
arthrogram and Isotope bone scan.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
25
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding normal gait in a person and some abnormal gaits seen in Orthopaedic
parctice.
2. LEARNING OBJECTIVES
Be able to identify or suspect a given pathology in a patient by understanding the gait
presented by the patient and help initiate care and treatment with the understanding of
the likely disease process.
3. CONTENTS
Definition, normal gait, phases in a gait cycle, analyzing gait in a patient and certain
abnormal gaits.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
26
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the definition, causes, classification, deformities, clinical features and
principles in management of cerebral palsy and poliomyelitis.
2. LEARNING OBJECTIVES
Be able to identify these conditions in a child and initiate care and treatment with the
understanding of the principles in its management
3. CONTENTS
Definition, etiology, deformities and their causes, types, pathology, clinical features,
and principles in management of cerebral palsy and poliomyelitis.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
27
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Class room
1. AIM / GOAL
Understanding the definition, etiology, pathology, clinical features, investigations and
principles in management of deformities of the axial and appendicular skeleton.
2. LEARNING OBJECTIVES
Be able to identify deformities and suspect possible causes in a patient and initiate
care and treatment with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, types, pathology, clinical features, investigations and principles
in management of deformities of the axial and appendicular skeleton.
4. TEACHING METHODS: Small group teaching
5. REFERENCES
a)
b)
c)
d)
28
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the etiology, clinical features, deformities, diabetic ulcers,
investigations and principles in management of diabetic foot.
2. LEARNING OBJECTIVES
Be able to identify Orthopaedic complications of diabetes in a patient and initiate care
and treatment with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, pathology, clinical features, deformities, investigations and
principles in management and care of the diabetic foot.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
29
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Lecture hall
1. AIM / GOAL
Understanding the etiology, types, pathology, pathogenesis, clinical features,
investigations, principles in management and complications of Osteomyelitis and
septic arthritis .
2. LEARNING OBJECTIVES
Be able to identify or suspect Osteomyelitis or septic arthritis in a patient and initiate
care and treatment with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, types, pathology, pathogenesis, clinical features, differential
diagnosis, investigations, principles in management and complications of
Osteomyelitis and septic arthritis.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
30
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (2 Hours)
: Lecture hall
1. AIM / GOAL
Understanding the etiology, pathology, clinical features and tests, investigations and
principles in management of certain common soft tissue lesions (Tennis elbow, carpal
tunnel syndrome and trigger finger).
2. LEARNING OBJECTIVES
Be able to identify or suspect these conditions in a patient and initiate care and
treatment with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, types, pathology, clinical features and tests, investigations and
principles in management of Tennis elbow, carpal tunnel syndrome and trigger finger.
4. TEACHING METHODS: Small group teaching
5. REFERENCES
a)
b)
c)
d)
31
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (2 Hours)
: Lecture hall
1. AIM / GOAL
Understanding the etiology, deformities, types, pathology, clinical features,
investigations and differential diagnosis and principles in management certain soft
tissue lesions seen in Orthopaedics practice.
2. LEARNING OBJECTIVES
Be able to identify or suspect these conditions in a patient and initiate care and
treatment with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, deformities, types, pathology, clinical features, investigations
differential diagnosis and principles in management of Periarthritis shoulder,
supraspinatus tendonitis, deQuervains disease, Plantar fascitis and Dupuytrens
contracture
4. TEACHING METHODS: Small group teaching
5. REFERENCES
a) Apleys System of Orthopaedics and Fractures
32
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the etiology, common sites, types, pathology, clinical features,
investigations differential diagnosis and principles in management of tuberculosis of
the spine and Potts paraplegia.
2. LEARNING OBJECTIVES
Be able to identify or suspect this condition in a patient and initiate care and treatment
with the understanding of the principles in its management
3. CONTENTS
Etiology, common sites, types, pathology, clinical features, investigations, differential
diagnosis and principles in management of tuberculosis of the spine and Potts
paraplegia.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a) Apleys System of Orthopaedics and Fractures
33
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Lecture hall
1. AIM / GOAL
Understanding the incidence, risk factors, types, stages, pathology, clinical features,
investigations differential diagnosis and principles in management of tuberculous
arthritis / tuberculosis of the hip joint.
2. LEARNING OBJECTIVES
Be able to identify or suspect this condition in a patient and initiate care and treatment
with the understanding of the principles in its management
3. CONTENTS
Incidence, etiology, types, stages, pathology, clinical features, investigations,
differential diagnosis and principles in management of tuberculous arthritis /
tuberculosis of the hip joint.
4. TEACHING METHODS: Didactic lecture
34
5.
REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the incidence, risk factors, causes, stages, pathology, clinical features,
investigations differential diagnosis and principles in management of IVDP and
spondylolisthesis.
2. LEARNING OBJECTIVES
Be able to identify or suspect this condition in a patient and initiate care and treatment
with the understanding of the principles in its management
3. CONTENTS
Incidence, risk factors, etiology, types, causes, stages, pathology, clinical features,
investigations, differential diagnosis and principles in management of tuberculous
arthritis / tuberculosis of the hip joint.
35
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the classification, common investigations, staging, and method of
treatment of bone tumors in general and specifically regarding Ostoid osteoma,
Osteochondroma, Enchondroma,simple bone cyst, Aneurysmal bone cyst and Giant
cell tomor
2. LEARNING OBJECTIVES
Be able to identify or suspect these conditions in a patient and initiate care and
treatment with the understanding of the principles in its management
36
3. CONTENTS
Classification, types, investigations, staging, and method of treatment of bone tumors
in general and specific information regarding Ostoid osteoma, Osteochondroma,
Enchondroma,simple bone cyst, Aneurysmal bone cyst and Giant cell tomor
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the classification, types, clinical features, investigations, staging, and
method of treatment of Osteosarcoma, Chondrosarcoma, Ewings sarcoma and
Multiple myeloma.
2. LEARNING OBJECTIVES
Be able to identify or suspect these conditions in a patient and initiate care and
treatment with the understanding of the principles in its management
37
3. CONTENTS
Classification, common investigations, staging, and method of treatment of bone
tumors in general and specific information regarding Osteosarcoma,
Chondrosarcoma, Ewings sarcoma and Multiple myeloma.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Lecture hall
1. AIM / GOAL
Understanding the etiology, types, pathology, clinical features, investigations,
differential diagnosis and principles in management of Osteoarthosis.
2. LEARNING OBJECTIVES
Be able to identify or suspect this condition in a patient and initiate care and treatment
with the understanding of the principles in its management
3. CONTENTS
38
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Lecture hall
1. AIM / GOAL
Understanding the etiology, types, pathology, clinical features, investigations,
differential diagnosis and principles in management of Gout.
2. LEARNING OBJECTIVES
Be able to identify or suspect this condition in a patient and initiate care and treatment
with the understanding of the principles in its management
39
3. CONTENTS
Definition, etiology, types, pathology, clinical features, investigations and principles
in management of Gout.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Lecture hall
1. AIM / GOAL
Understanding the definition, etiology, susceptible sites, pathogenesis, pathology,
clinical features, investigations and principles in management of Avascular necrosis
of the bone.
2. LEARNING OBJECTIVES
40
Be able to identify or suspect this condition in a patient and initiate care and treatment
with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, susceptible sites, pathogenesis, pathology, clinical features,
investigations, radiology (staging) and principles in management of Avascular
necrosis of the bone.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Lecture hall
1. AIM / GOAL
Understanding the definition, etiology, pathogenesis, pathology, clinical features,
investigations and principles in management of Perthes disease.
2. LEARNING OBJECTIVES
41
Be able to identify or suspect this condition in a patient and initiate care and treatment
with the understanding of the principles in its management
3. CONTENTS
Definition, etiology, pathogenesis, pathology, clinical features, investigations,
radiology (staging/grading) and principles in management of Perthes disease.
4. TEACHING METHODS: Didactic lecture
5. REFERENCES
a)
b)
c)
d)
42
43
44
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Tutorial: Amputations
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
Basics of Amputation: types / classification, indications, levels of amputation in
upper / lower limb, steps in amputation and complications of amputations.
2. LEARNING OBJECTIVES
Should be able to identify the indications for an amputation. Identify the
complications when present and be able to initiate its management with the
understanding of the basic principles.
3. CONTENTS
Definition of amputation, classification and types, levels of amputation, steps of
amputation, definition of stump, ideal stump, management of stump and
complications of amputations.
4. TEACHING METHODS: Tutorial
5. REFERENCES
a)
b)
c)
d)
45
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Tutorial: Tourniquette
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
Understanding the basics of tourniqettes used in Trauma and orthopaedic surgery.
2. LEARNING OBJECTIVES
Should be able to know the different types of tourniqettes used in Orthopaedics
Surgery,method of appllying,indications and contraindications for its use.
3. CONTENTS
Tourniqette
4. TEACHING METHODS: Tutorial and demonstration
5. REFERENCES
a)
b)
c)
d)
46
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Tutorial: Prosthesis
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
Understanding the basics of a prosthetics, different types, parts of prosthesis and its
function in amputees.
2. LEARNING OBJECTIVES
Should be able to define,identify the different types of prosthesis and understand the
basic principles.
3. CONTENTS
Definition of prosthesis, its parts and different types of prosthesis.
4. TEACHING METHODS: Tutorial and demonstration
5. REFERENCES
a)
b)
c)
d)
47
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Tutorial: Orthotics
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
Basics of Orthoses: types / classification, International terminologies used.
2. LEARNING OBJECTIVES
Should be able to define, identify different types of orthoses and know its indication
in different orthopaedic conditions.
3. CONTENTS
Definition of orthoses, International terminologies used, and types and indications for
orthoses
4. TEACHING METHODS: Tutorial and demonstration
5. REFERENCES
a)
b)
c)
d)
48
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
Understanding the basics of common implants and instruments used in Trauma and
orthopaedic surgery.
2. LEARNING OBJECTIVES
Should be able to identify basic implants and instruments and know its use in various
Orthopaedic surgeries.
3. CONTENTS
Implants and Instruments
4. TEACHING METHODS: Tutorial and demonstration
5. REFERENCES
a) Apleys System of Orthopaedics and Fractures
b) Book of Orthopaedics and Traumatology: M Natarajan & Mayilvahanan Natarajan
c) Essential Orthopaedics : J. Maheshwari
e) Clinical Oriented Anatomy: Keith Moore and Arthur Dalley
49
PROG
: M.B.B.S
SEMESTER : 8 & 9
TOPIC
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
Reading an x-ray and understanding the basics of radiological features in various
Trauma and Orthopaedic conditions.
2. LEARNING OBJECTIVES
Should be able to identify the fractures of different long bones and also the
radiological features in different Orthopaedic conditions .
5. CONTENTS
Common Trauma and Orthopaedic x-rays
4. TEACHING METHODS: Demonstration
5. REFERENCES
a)
b)
c)
d)
50
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
51
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
52
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
53
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
54
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
55
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
56
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
57
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
58
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
59
PROG
: M.B.B.S
SEMESTER : 8 & 9
TOPIC
: PBL: Metabolic bone diseases ( Rickets, Osteomalacia, Osteoporosis)Clinical Scenarios.
DAY / DATE : As per schedule
VENUE
DURATION: (1 Hour)
60
PROG
: M.B.B.S
SEMESTER : 8 & 9
TOPIC
DURATION: (1 Hour)
61
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
62
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: PBL: Fractures: Healing,classification,methods of treatment &
complications
DAY / DATE : As per schedule
VENUE
DURATION: (1 Hour)
63
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
With the basic knowledge of various major muscles of upper limb,to learn the method
of testing these muscles
2. LEARNING OBJECTIVES
Should be able to test individual muscles and grade its power and apply in clinical
practice.
3. CONTENTS
Testing of muscles of Upper limb.
4. TEACHING METHODS: Small group teaching & Demonstration.
5. REFERENCES
a)
b)
c)
d)
64
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
With the basic knowledge of various major muscles of lower limb,to learn the method
of testing these muscles
2. LEARNING OBJECTIVES
Should be able to test individual muscles and grade its power and apply in clinical
practice.
3.CONTENTS
Testing of muscles of Lower limb.
4. TEACHING METHODS: Small group teaching & Demonstration.
5. REFERENCES
a)Snells textbook of Anatomy,7th edition.
b) Book of Orthopaedics and Traumatology: M Natarajan & Mayilvahanan Natarajan
c) Essential Orthopaedics : J. Maheshwari
d) Clinical Oriented Anatomy: Keith Moore and Arthur Dalley
65
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
limbs.
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
With the basic knowledge of major nerves of upper limbs,to learn special tests for
each nerve.
2. LEARNING OBJECTIVES
Should be able to test individual nerves of upper limbs(Median,ulnar,radial & axillary
nerve) & apply it in clinical practice.
3.CONTENTS
Special tests for individual nerves of Upper limbs.
4. TEACHING METHODS: Small group teaching & Demonstration.
5. REFERENCES
a)Snells textbook of Anatomy,7th edition.
b)Book of Orthopaedics and Traumatology: M Natarajan & Mayilvaha nan Natarajan
c)Essential Orthopaedics : J. Maheshwari
d)Clinical Oriented Anatomy: Keith Moore and Arthur Dalley
66
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
limbs.
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
With the basic knowledge of major nerves of Lower limbs,to learn special tests for
each nerve.
2. LEARNING OBJECTIVES
Should be able to test individual nerves of Lower limbs(Median,ulnar,radial &
axillary nerve) & apply it in clinical practice.
3. CONTENTS
Special tests for individual nerves of Lower limbs.
4. TEACHING METHODS: Small group teaching & Demonstration.
5. REFERENCES
a)Snells textbook of Anatomy,7th edition.
b)Book of Orthopaedics and Traumatology: M Natarajan & Mayilvahanan Natarajan
c)Essential Orthopaedics : J. Maheshwari
d)Clinical Oriented Anatomy: Keith Moore and Arthur Dalley
67
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Small group teaching : Special tests & signs for individual joints
DURATION: (1 Hour)
: Skill laboratory
1. AIM / GOAL
To learn some special tests and signs for various joints of upper and lower limbs.
2. LEARNING OBJECTIVES
Should be able learn the special tests and signs for major joints of the
limbs(Hip,knee,shoulder & elbow joint) and apply them in clinical practice.
3.CONTENTS
Special tests and signs for individual joints-Upper & Lower limbs.
4. TEACHING METHODS: Small group teaching & Demonstration.
5. REFERENCES
a)Snells textbook of Anatomy,7th edition.
b)Book of Orthopaedics and Traumatology: M Natarajan & Mayilvahanan Natarajan
c)Essential Orthopaedics : J. Maheshwari
d)Clinical Oriented Anatomy: Keith Moore and Arthur Dalley
68
PROG
: M.B.B.S
SEMESTER : 6 & 7
TOPIC
: Self-Directed Learning
DURATION: (2 Hours)
: Small rooms
1.AIM / GOAL
a) To cover some of the minor topics which are not included in the major
curriculum.
b) Allowing the students to get insight into some topics in depth.
c) To develop the skills of interpreting Clinical Anatomy/Clinical
scenarios.
d) To develop the skill of E-learing & internet use for Research
purposes.
2. LEARNING OBJECTIVES
Student should be able to analyse,correlate and reason out the facts related to Basic
Anatomy,Data interpretation,Plan of management of a given problem.
3.CONTENTS
a) Anatomy diagrams with some clinical Scenarios to correlate.
b) Clinical scenarios to check the skill of reasoning out.
c) Research programme related to the given problem.
4. TEACHING METHODS: Self-Directed Learning(unde r minimal
supervision)
5. EVALUATION
a) Group discussion in a small room
b) Assessment in terms of achieving the aims.
c) Continuous assessment
69
6. REFERENCES
a)Snells textbook of Anatomy,7th edition.
b)Book of Orthopaedics and Traumatology: M Natarajan & Mayilvahanan Natarajan
c)Essential Orthopaedics : J. Maheshwari
d)Clinical Oriented Anatomy: Keith Moore and Arthur Dalley
e)Apleys System of Orthopaedics & Fractures.
70
Assessment:
71
72
Learning Outcomes
73
Overall Goal:
The broad goal of the teaching of undergraduate students in Community Medicine is to
prepare them to function as first level physicians in the community, health care centers,
hospitals and other health institutions in accordance with the institutional goals.
Objectives:
A) Knowledge:
At the end of the course, the student shall be able to:
1) describe the health care delivery system including rehabilitation of the disabled in
the country;
2) describe the National Health Programmes with particular emphasis on maternal
and child health programmes, family welfare planning, and population control;
3) list epidemiological methods and describe their application to communicable and
non-communicable diseases in the community or hospital situation;
4) apply biostatistical methods and techniques;
5) outline the demographic pattern of the country and appreciate the roles of the
individual, family, community and socio-cultural milieu in health and disease;
6) describe the health information systems;
7) enunciate the principles and components of primary health care and the national
health policies to achieve the goal of Health For All;
8) identify the environmental and occupational hazards and their control;
9) describe the importance of water and sanitation in human health;
10) to understand the principles of health economics, health
administration, health education in relation to community.
B) Skill:
At the end of the course, the student shall be able to:
1) use epidemiology as a tool to make rational decisions relevant to community and
individual patient intervention;
74
2) collect, analyse, interpret and present simple community and hospital-based data;
3) diagnose and manage common health problems and emergencies at the
individual, family and community levels keeping in mind the existing health care
resources and in the context of the prevailing of the prevailing socio-cultural
beliefs;
4) diagnose and manage maternal and child health problems and advise a couple and
the community on the family welfare planning methods in the context of the
national priorities;
5) diagnose and manage common nutritional problems at the individual and the
community level;
6) plan, implement and evaluate a health educational programme with skill to use
simple audio-visual aids;
7) interact with other members of the health care team and participate in the
organization of health care services and implementation of national health care
programmes.
C) Integration:
Develop capabilities of synthesis between cause of illness in the environment or
community and individual health and respond with leadership qualities to institute
remedial measures for this.
75
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
v.
Concepts of health.
Concepts of disease.
Spectrum of health and disease.
Natural history of disease.
Determinants of health.
3.
Readings:
i.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
Levels of prevention.
Modes of intervention.
Types of rehabilitation.
3.
Readings:
i.
76
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
3.
Readings:
i.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
3.
Readings:
i.
ii.
iii.
77
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
3.
Readings:
i.
ii.
iii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
78
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
iii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
iii.
79
Lecture 9: Demography
No.
1.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
Demographic cycle.
Dependency ratio and its uses.
Fertility indicators.
3.
Readings:
i.
ii.
80
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
81
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
Sources of water.
Water treatment types and processes.
Solid waste disposal open dumping,
sanitary landfill, incineration, etc.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
http://en.wikipedia.org/wiki/Nonionizing_radiation
http://en.wikipedia.org/wiki/Ionizing_radiation
ii.
82
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
83
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
http://www.clario.org/clario_building_a_procedure_for_tqm_in_lasik.php
http://www.publichealth.pitt.edu/supercourse/SupercoursePPT/1701118001/17501.ppt
84
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
Scope of epidemiology.
Aims of epidemiology
Epidemiological approach.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
3.
Readings:
i.
ii.
85
iii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
Types of carriers.
Epidemic, endemic and pandemic.
Herd immunity.
3.
Readings:
i.
ii.
iii.
86
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
Definition of death.
Guidelines of medical certificate of death.
International Classification of Disease ICD
10
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
3.
Readings:
i.
87
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
Measurements of mortality
Crude death rate and age specific death rate.
Calculation of standardized death rate.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
88
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
89
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
Item
Outcomes:
Outline
i.
ii.
iii.
iv.
2.
Contents:
i.
ii.
iii.
iv.
3.
Readings:
i.
ii.
iii.
90
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
iii.
Able to illustrate
concepts relating
Able to illustrate
concepts relating
the epidemiological
to Viral Hepatitis A.
the epidemiological
to Poliomyelitis.
Item
Outcomes:
Outline
i.
ii.
iii.
iv.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
iii.
91
Item
Outcomes:
Outline
i.
ii.
Able to illustrate
concepts relating
Able to illustrate
concepts relating
the epidemiological
to Diphtheria.
the epidemiological
to Tuberculosis.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
iii.
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
3.
Readings:
i.
ii.
iii.
92
No.
1.
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
3.
Readings:
i.
ii.
iii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
3.
Readings:
i.
ii.
iii.
93
Item
Outcomes:
Outline
i.
ii.
Able to illustrate
concepts relating
Able to illustrate
concepts relating
the epidemiological
to Hepatitis B.
the epidemiological
to HIV / AIDS.
2.
Contents:
i.
ii.
3.
Readings:
i.
ii.
iii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
Classification of zoonosis.
The epidemiology of Rabies.
The epidemiology of Plague.
3.
Readings:
i.
ii.
iii.
94
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
3.
Readings:
i.
ii.
iii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
Definition of screening.
Concept of screening time and lead time.
Characteristics of a proper screening test.
Sensitivity vs specificity.
3.
Readings:
i.
ii.
95
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
Objectives of surveillance.
Core functions of surveillance.
Surveillance: data flow.
3.
Readings:
i.
ii.
iii.
iv.
v.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
3.
Readings:
i.
ii.
96
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
iv.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
97
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
iii.
iv.
http://www.dph.gov.my/vektor/akta/ddbia_2000.htm
http://www.jknsel.moh.gov.my/penerangan.php?id=27&page=5
http://www.pkdsetiu.com/viewpage.php?page_id=22
http://www.dph.gov.my/cdc/downloads/law/Regulation%
20Import%20Eksport.pdf
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
3.
Readings:
i.
98
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
99
Item
Outcomes:
Outline
i.
ii.
2.
Contents:
i.
ii.
iii.
Classification of diabetes.
The epidemiology of NIDDM.
Prevention and control of NIDDM.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
iii.
2.
Contents:
i.
ii.
iii.
3.
Readings:
i.
ii.
100
Item
Outcomes:
Outline
i.
ii.
Able to illustrate
concepts relating
Able to illustrate
concepts relating
cancer.
the epidemiological
to cervical cancer.
the epidemiological
to stomach and lung
2.
Contents:
i.
ii.
3.
Readings:
i.
ii.
Item
Outcomes:
Outline
i.
ii.
2.
3.
Contents:
Readings:
i.
ii.
iii.
i.
http://www.who.int
101
Item
Outcomes:
Outline
i.
ii.
2.
3.
Contents:
Readings:
i.
ii.
iii.
i.
http://www.osha.gov
102
1.
LEARNING OUTCOMES:
At the end of the practical course, the student shall be able to:
1.1.1 Describe the various types of study designs available.
1.1.2 Identify the various measures of association used in these various study
designs.
1.1.3 Come up with a report detailing the study and incorporating the IMRAD
(introduction, methodology, results and discussion) system.
1.1.4 Interpret basic statistical tools used in journals /articles.
1.1.5 Read a paper / article and come up with flaws / limitations pertaining to
the study.
CONTENTS
1. Introduction to epidemiological studies
2. Writing a report
3. Descriptive study
4. Cross sectional study
5. Case control study
6. Cohort study
7. Experimental study
8. Measures of association
9. Literature review
10. Sample size calculation
11. Designing questionnaire
1.2
INTRODUCTION
METHODOLOGY
RESULTS
DISCUSSION & CONCLUSION
103
Learning Outcomes
At the end of the module the student shall be able to:
1. Have basic knowledge in the components of a published research paper
2. Describe in detail the good points and negative points of a published paper
3. Write a scientific paper based on guidelines listed for each component of the
manuscript
Essential Contents
a)
Basic contents
b)
Basic contents
c)
Basic contents
d)
Basic contents
/ components
/ components
/ components
/ components
- Introduction
- Methodology
- Results
- Discussion
Student Presentations
Journal Critique I
Journal Critique II
Journal Critique III
104
Employ basic techniques for data collection, recording, coding & summary.
Present & interpret data in the form of indices, tables, charts & diagrams.
Process, compile & evaluate data with the use of basic statistical methodology
Discuss & communicate quantitative problems & their solutions in a quantitative
manner
Read, understand, interpret & criticise objectively research reports & papers
To utilise the computer & application software as statistical tools
Essential Contents
a)
b)
c)
d)
e)
f)
g)
h)
i)
Introduction to Biostatistics
Sampling techniques
Quantitative and qualitative data
Data presentation
Measures of central tendency
Measures of dispersion
Distribution Pattern
Hypothesis testing
Correlation and regression
OBJECTIVES:
At the end of the problem based learning sessions, the student shall be able to:
1.1.1
1.1.2
1.1.4
1.1.5
Students will receive health topics at the beginning of each week. Students will
then go through the PBL process (as depicted below) before making a
professional presentation the following week.
105
106
107
Learning Outcomes
108
109
Developmental Assessment
After this lecture session student should
1. Be able to describe normal growth.
2. Be able to describe normal development
3. Recognize the influence of heredity and environment on growth & dev.
4. Know how to measure weight, length, head circumference and plot on charts.
5. Be aware of tools used (eg DDST) to screen development.
6. Be able to detect growth problems and detect delays in development
110
1. Be aware of the Human Genome Project and its culmination in Human Genome
Sequence in 2001, and the availability of databases.
2. Be able to explain the basics of genetic disorders chromosomal abnormalities,
Mendelian inheritance, polygenic inheritance
3. Recognise terms used in dysmorphology.
4. Should be able to describe common genetic disorders, be aware of burden of
genetic disease and know principles of genetic counselling.
5. Should know clinical application of the newer advances.
Suggested further reading:
1. Illustrated textbook of Paediatrics Lissauer & Clayden, 3rd edition.
4. Lecture topic: Learning Difficulty; Emotional / Behavior Disorders
After this lecture session student should:
1 Recognise terms used in learning difficulty and developmental delay.
2 Know causes of learning difficulty and developmental delay.
3 Be able to evaluate learning difficulty and developmental delay and propose
appropriate investigations.
4 Be able to recall triad of difficulties and co-morbidities in autism.
5 Be able to differentiate the normally active from the hyperactive child.
6 Recognise common problems of nocturnal enuresis, constipation/ soiling,
Suggested further reading:
1. Illustrated textbook of Paediatrics Lissauer & Clayden, 3rd edition.
________________________________________________________________________
5. Lecture topic: Failure to thrive (FTT)
After this lecture session student should:
1. Be able to define FTT and recognize / detect it on growth charts.
2. Be able to list causes of FTT.
3. Demonstrate the skill to evaluate FTT utilizing the growth charts in combination
with a focused history and examination.
4. Be able to list investigations to be considered in FTT and select appropriate
investigation according to likely diagnosis.
5. Be able to plan management of a child with non-organic FTT.
Suggested further reading:
1
Illustrated textbook of Paediatrics Lissauer & Clayden, 3rd edition.
2.
3.
4.
5.
6.
112
113
114
4. Have a general idea about the skills and equipments used in managing a critically
ill child like intubation, oxygen therapy, ventilators and monitoring.
5. Have an idea about other issues in critical care like transportation and nutrition of
a sick child, brain death and other ethical issues and importance of counseling of
parents
.
Suggested further reading:
1. NMS Pediatrics Paul H. Dwarkin, 4th edition
2. Nelson Essentials of Pediatrics Behrman, Kliegman
15. Lecture topic: UTI/VUR
After this lecture session student should:
1. Be able to recall the aetiopathogenesis of urinary tract infection and vesicoureteric reflux in children.
2. Be able to recall the symptoms and signs of a child presenting with urinary tract
infection.
3. Be able to list the investigations done to diagnose the above conditions.
4. Be able to outline the management of a case of urinary tract infection and vesicoureteric reflux
5. Be able to list the complications of the above conditions.
Suggested further reading:
1. Paediatric nephrology. Srivastava, Bagga.
2. Nelson Essentials of Pediatrics Behrman, Kliegman
16. Lecture topic: FLUID RESUSCITATION IN SPECIAL SITUATIONS
After this lecture session student should:
1. Be able to recall about the fluid homeostasis with special reference to paediatric
population.
2. Be able to list various fluids available for therapeutic use including their
indications.
3. Be able to calculate normal maintenance fluid requirement in a child according to
body weight.
4. Be able to calculate the fluid deficit in a child with acute gastroenteritis with
various grades of dehydration.
5. Be able to explain the fluid management in a child with dengue shock syndrome
and burns.
Suggested further reading:
1. Clinical Practice Guidelines. Management of dengue fever in children. MOH
Malaysia.
2. Nelson Essentials of Pediatrics Behrman, Kliegman
115
116
Suggested reading:
Illustrated Textbook of Paediatrics Lissauer & Clayden, 3rd edition.
117
118
Topic: Vomiting
At the
1.
2.
3.
Topic: Jaundice
At the
1.
2.
3.
119
Topic: Hematuria
At the end of this session student should:
1. Be able to define microscopic hematuria
2. Be able to recall few common causes of hematuria in children depending on age.
3. Have the requisite skill to analyze and interpret various scenarios with hematuria..
Topic: Seizures
At the end of this session student should be able to:
1. Define seizure, convulsion and epilepsy.
2. List different types of seizures / 1-2 epileptic syndromes
3. List common causes of seizures.
4. Differentiate seizures from events mimicking seizures.
5. Interpret and analyze various clinical scenarios involving seizures.
Topic: Drowsiness
After this session student should:
1. Be able to use modified Glasgow coma scale for children.
2. Know the different causes of altered sensorium in a child.
3. Have capability to analyze and interpret scenarios involving drowsiness.
Topic: Fluid and Electrolyte therapy
After this session student should:
1. Be able to describe the water, sodium, potassium and bicarbonate homeostasis .
2. Be able to recall the contents of various types of commonly used IV Fluids.
3. Have the capability to choose an appropriate fluid for management of shock,
replacement therapy for dehydration and maintenance therapy.
_____________________________________________________________________
Topic: Pallor
After this session student should be able to:
1. List important causes of anemia in infants and children.
2. Clinically differentiate between them.
3. Interpret and analyse various clinical scenarios involving pallor.
_____________________________________________________________________
120
Topic: Investigations
After this session student should:
1. Know that normal values vary with age eg. Hb, SAP.
2. Be aware of investigations in common diseases.
3. Be aware of various categories of investigations
4. Be able to confirm/rule out differential diagnosis based on investigations
5. Be able to do baseline investigations in ill/chronic patients.
6. Be able to do investigations for screening and for prognosis/monitoring of
complications.
_____________________________________________________________________
Topic: Antibiotics
After this session student should:
1. Know that choice of antibiotic depends on the age /patient/likely causative
organism.
2. Know that viral infection should not be treated with antibiotic.
3. Know that samples be taken for culture and sensitivity before blindly prescribing
antibiotics, which may lead to difficulty in diagnosis.
4. Know prevalent organism and its sensitivity is of great help in antibiotic selection.
5. Be aware that dose, route and duration of treatment can vary.
6. Know the adverse effects of the antibiotic used.
7. Select antibiotics according to various scenarios.
________________________________________________________________________
121
DEPARTMENT OF PAEDIATRICS
LEARNING OUTCOMES: CLINICAL TEACHING
122
123
Learning Outcomes
124
Skills
At the end of the course, the student should be able to
1. Elicit a good history, examine and diagnose common ear, nose and throat
problems.
2. Manage all ear, nose and throat problems at the primary level
3. Interpret the Pure tone audiograms
4. Care of tracheostomy patient
5. Recognize cases which needs immediate and long term specialist care and refer
them accordingly.
Integration:
Develop the right attitude and commitment to deliver the best possible medical care
for his/her patients and maintain confidentiality. Uphold the principles of ethical
conduct in all his dealings with patients.
125
Department of ENT
Melaka Manipal Medical College
Programme: MBBS
Semester 6 & 7 (Lecture Topics)
ENT Theory Learning Outcomes (Semester 6 & 7)
Lecture 1: Anatomy of Ear &Physiology of Hearing
No.
1.
Item
Outcomes:
2.
Readings:
Outline
I. To understand and describe anatomy of the ear.
II. Able to draw labeled diagram of ear
III. To discuss the Physiology of hearing and
equilibrium
I. Diseases of ear, nose and throat- P L Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
Item
Outcomes:
2.
Readings:
Outline
I. To recognize the type and degree of hearing
loss
II. To analyze and identify the site of hearing loss
III. To interpret the pure tone audiogram
I.
II.
III.
IV.
V.
126
Item
Outcomes:
2.
Readings:
Outline
I.
Item
Outcomes:
2.
Readings:
Outline
I.
To define acute suppurative otitis
media and serous otitis media
II.
To diagnose acute suppurative otitis
and
serous otitis media
III.
To manage acute suppurative otitis
and
serous otitis media
I.
II.
III.
IV.
V.
127
Lecture 5: CSOM-TTD
No.
1.
Item
Outcomes:
2.
Readings:
Outline
I.
II.
IV.
V.
No.
1.
Item
Outcomes:
2.
Readings:
Outline
I.
IV.
V.
128
Item
Outcomes:
2.
Readings:
Outline
I. To define the Menieres disease
II. To diagnose and Enumerate the differential
diagnosis of Menieres disease
III. To manage Menieres disease
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
Lecture 8: Otosclerosis
No.
1.
Item
Outcomes:
2.
Readings:
Outline
I. To define Otosclerosis
II. To diagnose and Enumerate the differential
diagnosis otosclerosis
III. To manage otosclerosis
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
129
Readings:
I.
II.
III.
IV.
V.
Readings:
I.
II.
III.
IV.
V.
130
Item
Outcomes:
2.
Readings:
Outline
I. Define deaf mutism
II. To list the causes of deaf mutism
III. To able to evaluate and diagnose a deaf
child.
IV. To manage deaf mutism
I.
II.
III.
IV.
V.
Item
Outcomes:
2.
Readings:
Outline
I. Able to classify tumours of ear.
II. Able to diagnose Acoustic neuroma and
glomus tumour.
III. Describe the management plan for Acoustic
neuroma and glomus tumour.
I.
II.
III.
IV.
V.
131
Item
Outcomes:
Outline
I.
II.
III.
IV.
2.
Readings:
Item
Outcomes:
2.
Readings:
Outline
I. Able to list the diseases of external nose
II. To recognize and differentiate the diseases
of external nose
III. To manage the diseases external nose
132
Lecture 15: Facial Trauma, CSF rhino rhea & Fracture nasal bone
No.
1.
Item
Outcomes:
Outline
I.
II.
III.
2.
Readings:
No.
1.
Item
Outcomes:
2.
Readings:
Outline
I. Define acute and chronic sinusitis
II. Describe and differentiate clinical features
of acute and chronic sinusitis
III. To manage acute and chronic sinusitis
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
133
Item
Outcomes:
Outline
I.
II.
III.
2.
Readings:
Item
Outcomes:
Outline
I.
II.
III.
IV.
2.
Readings:
134
Item
Outcomes:
Outline
I.
II.
III.
2.
Readings:
Item
Outcomes:
2.
Readings:
Outline
I. Able to classify Benign & malignant
tumors of nose.
II. Able to diagnose juvenile
nasopharyngeal carcinoma and
carcinoma maxilla
III. Describe the management plan for
juvenile nasopharyngeal carcinoma and
carcinoma maxilla
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
135
Item
Outcomes:
2.
Readings:
Outline
I. Enumerate the etiopathogenesis of
nasopharyngeal carcinoma.
II. Enumerate the clinical features of NPC
III. Able to diagnose nasopharyngeal carcinoma
IV. Describe the management of
nasopharyngeal carcinoma
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
Item
Outcomes:
2.
Readings:
Outline
I. To understand and describe anatomy of
pharynx and larynx.
II. Able to draw ILS findings of laryngeal inlet
III. To discuss the Physiology of pharynx and
larynx
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
136
Item
Outcomes:
2.
Readings:
Outline
I.
II.
III.
IV.
V.
Item
Outcomes:
Outline
I.
II.
III.
2.
Readings:
137
No.
1.
Item
Outcomes:
2.
Readings:
Outline
I. Define acute and chronic laryngitis
II. Describe and differentiate clinical features
of acute and chronic laryngitis
III. To manage acute and chronic laryngitis
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
Item
Outcomes:
2.
Readings:
Outline
I. Enumerate various benign laryngeal
disorders
II. Describe the clinical features of various
benign laryngeal disorders
III. Outline management of benign laryngeal
disorders
138
Item
Outcomes:
2.
Readings:
Outline
I. Enumerate the etiopathogenesis of
Laryngeal & Pharyngeal Malignancies
II. To enumerate the clinical features of
pharyngeal and laryngeal malignancies.
III. Able to diagnose laryngeal and pharyngeal
malignancies
IV. Describe the management of laryngo
pharyngeal carcinoma
Item
Outcomes:
2.
Readings:
Outline
I. List the various foreign bodies in ear, nose
and throat
II. Able to diagnose common foreign bodies in
ear, nose and throat
III. Able to manage common foreign bodies in
ear, nose and throat
I. Diseases of ear, nose and throat- P L
Dhingra
II. Fundamentals of Ear, Nose and Throat
Diseases- S K De
III. Scott- Browns otolaryngology Alan G
Karr
IV. Otolaryngology- Head & Neck surgeryCummings
V. Colour Atlas of ENT diagnosis- TR Bull
139
Item
Outcomes:
Outline
I.
II.
III.
2.
Readings:
140
.
Specific Objectives:
Knowledge:
At the end of the posting he/she should be able to obtain a satisfactory history, perform
satisfactory clinical examination and plan management for a patient with following
problems.
1. Ear discharge
2. Hearing loss
3. Tinitus
4. Vertigo
5. Nasal discharge
6. Anosmia
7. Epistaxis
8. Sore throat
9. Hoarseness of voice
10. Dysphagia
11. Stridor
12. Foreign body in ENT
13. Headache and facial pain
14. Neck swellings
141
Skills
At end of the course, the student shall be able to perform:
1. Otoscopy
2. Tuning fork tests
3. Voice test
4. Ear syringing
5. Interpretation of Pure tone audiogram
6. Cold spatula test
7. Anterior rhinoscopy
8. Removal of Nasal foreign body
9. Anterior nasal packing
10. Throat examination
11. Neck examination
12. Tracheostomy care
At the end of the posting he/she should be able to obtain a satisfactory history, perform
satisfactory clinical examination and plan management for the following clinical cases.
142
Learning Outcomes:
1.
2.
3.
4.
5.
To
To
To
To
To
Learning Outcomes:
1.
2.
3.
4.
To
To
To
To
Topic 4: Epistaxis
Learning Outcomes:
1. To understand the vascular anatomy of nasal septum and lateral wall of the nose
2. To be conversant with causes of epistaxsis
3. To do a clinical evaluation of a patient with epistaxis
4. To discuss the management of epistaxis
143
Learning Outcomes:
1. To evaluate the causes of stridor
2. To evaluate the causes of hoarseness
3. To plan the investigations for patient with stridor and hoarseness
4. To review the treatment of common voice disorders
Topic 6: Tracheostomy
1.
2.
3.
4.
5.
To
To
To
To
To
Learning Outcomes:
1. To discuss the Human Immunodeficiency Virus infection
2. To recognize ENT manifestations in HIV/AIDS
3. To plan management for HIV patients in ENT.
Topic 8: Evaluation of a case of dysphagia
Learning Outcomes:
1.
2.
3.
4.
5.
To
To
To
To
To
Learning Outcomes:
1.
2.
3.
4.
To
To
To
To
144
Learning Outcomes
145
OVERALL GOAL:
The broad goal of the teaching of undergraduate students in Surgery is to produce
graduates capable of delivering efficient first contact surgical care.
SKILLS CENTRE
At the
Given
end of the course, in a simulated trauma patient the student should be able to:
identify life threatening injuries; and
demonstrate the management of trauma using the ATLS protocol.
the appropriate task by the trainer, the student should be able to:
146
perform an adequate surgical scrub and wear sterile gown and gloves
correctly.
At the end of the course, in a given surgical mannequin, the student should be able to:
147
AFFECTIVE
At the end of the semester, the student should be able to:
demonstrate the professional behaviour expected of a medical student with
patients and colleagues,
communicate effectively to obtain information and
practice ethical medicine, following the established principles of ethical practice
and guidelines of Ministry of Health, Malaysia.
148
149
150
151
152
153
154
155
156
157
158
159
list the complications of peripheral arterial and venous diseases and outline the
principles of their management.
160
161
162
163
AFFECTIVE
At the end of the semester, the student should be able to:
demonstrate the professional behaviour expected of a medical student with
patients and colleagues,
communicate effectively to obtain and provide information and
practice ethical medicine, following the established principles of ethical practice
and guidelines of Ministry of Health, Malaysia.
164
Semester 10
CLINICAL LEARNING OUTCOMES FOR FINAL YEAR (Semester 10)
1. Overall Outcome:
At the end of the semester the student should be able to demonstrate adequate
competency (as determined by the surgical department faculty and a panel of examiners)
in all the cognitive, psychomotor and affective domains as listed earlier for the overall
surgical course.
2. Objectives
At the end of Surgery posting student must be able to: analyse the nature of problems related to medical care, develop knowledge and
understanding of disease processes,
apply skills acquired to obtain history, conduct clinical examination and formulate
a provisional diagnosis,
apply the skills acquired to communicate effectively both orally and in writing
with patients and relatives, with doctors and other members of the health care
team, within the hospital and community settings,
plan and conduct, if applicable, the necessary investigations,
safeguard patients and his own well-being by adopting all the necessary safety
precaution in handling equipments and biological materials,
conduct all interactions with patients and community in a professional manner, in
particular respect for dignity of patient, concern for relatives and awareness of
legal and ethical issues and
work as a member of the team respecting the roles of each and the contributions
they provide to ensure that comprehensive health care is given.
3. Content
165
To
To
To
To
LEARNING OUTCOMES
At the end of the session the student should be able to:
apply the principles of emergency management of acute abdomen and
Indicate non-surgical causes of acute abdomen.
Trauma
166
Learning Outcomes
167
168
Attitude
1. Empathy and compassion for patients and good bedside manners
2. Communicate effectively with patients and relatives
3. Team spirit, professionalism and good communication with colleagues
169
170
Lecture 6: Anatomical
Recall the anatomical changes in the external genitalia as well as uterus and cervix along
with the changes in their blood supply and should be able to enumerate the signs seen
with the changes in the organs.
Learning Outcome : The student should be able to
1. assess pregnancy in a woman
2. differentiate normal pregnancy from pathological conditions
Lecture 7: Antenatal care and high-risk pregnancy
Learning Objective : The student should
1.
be able to define aims and objectives of antenatal care
2.
recall the routine antenatal schedule
3.
be able to describe procedures and investigations at each scheduled visit
4.
formulate antenatal advice during these visits
5.
identify high risk pregnancy
6.
assess the significance of the same in developing countries
7.
be able to describe the screening procedures for the same
Learning Outcome : The student should be able to
1. offer routine antenatal care for a low-risk pregnancy, regarding nutritional
requirements, healthy lifestyle, iron proohylaxis, immunization and schedule for antenatal
visits.
2. identify high risk pregnancy based on history and physical examination.
Lecture 8: Facts about fetus and pelvis / mechanism of normal labor
Learning Objective : The student should
1. recall the areas of the fetal skull, anatomy of sutures, fontanelles, diameters of skull,
2. recall moulding and caput formation
3. describe pelvis, all the diameters and conjugates, boundaries of cavity, outlet and
midpelvis, understand pelvic axis and pelvic joints.
4. define mechanism of labour
5. be able to list all events in order and understand the mechanism behind each event.
Learning Outcome : The student should be able to
1. demonstrate the diameters on the fetal skull and their various positions in the maternal
pelvis
2. demonstrate the measurement of conjugates in the maternal pelvis
3. demonstrate the events in mechanism of labour
171
Lecture 9: Clinical features and management of normal labor - 1st and 2nd stage
Learning Objective : The student should
1. describe the clinical course of 1st and 2nd stages of labour , dilatation and taking up of
the cervix, rupture of membranes and descent of the fetus.
2. construct partogram
Learning Outcome : The student should be able to
1.identify the stage of labour based on clinical findings
2.construct a partogram
172
173
174
175
4. The student must know the etiology, clinical features and incidence of ectopic
pregnancy
5. The student must be able to list the investigations in ectopic pregnancy
6. The student must be able to describe treatment of different types of miscarriage
(e.g. evacuation of retained products of conception) and ectopic pregnancy
(expectant, medical and surgical)
Practical skills
1. The student must be able to clinically evaluate a lady with early pregnancy
bleeding and interpret the investigations (UPT, USG)
2. The student must be able to suggest medical and surgical options for a lady with
early pregnancy bleeding (different types of miscarriage and ectopic pregnancy)
based on patients presentation and eligibility criteria
3. The student must be able to recognize women presenting in shock (due to early
pregnancy complications like ruptured ectopic pregnancy)
Lecture 21: Gestational trophoblastic disease
Expected goal
The student must be able to clinically diagnose, manage and follow-up a lady with molar
pregnancy.
Theoretical knowledge
1. The student must understand the pathogenesis of gestational trophoblastic disease
2. The student must know the clinical features and complications of gestational
trophoblastic disease
3. The student must be able to list relevant investigations for gestational
trophoblastic disease
4. The student must know the modalities of treatment and follow-up
5. The student must know the role of chemotherapy (single and multi-agent) in highrisk patients
Practical skills
1. The student must be able to recognize and clinically diagnose gestational
trophoblastic disease
2. The student must be able to counsel a lady with gestational trophoblastic disease
regarding options for treatment based on age, parity and complications
3. The student must be able to follow-up a lady with gestational trophoblastic
disease and recognize persistant trophoblastic disease based on clinical features
and serum beta HCG.
176
Theoretical knowledge
Expected goal
The student must be able to clinically diagnose and manage a lady with diabetes mellitus
complicating pregnancy gestational diabetes mellitus & pre-gestational diabetes
mellitus
177
Theoretical knowledge
1. The student should describe the physiological changes in carbohydrate
metabolism
2. The student should explain the maternal and fetal effects of patients with
gestational diabetes mellitus or pre-gestational diabetes mellitus
3. The student should recall the definition and clinical features (risk factors for
GDM) of gestational diabetes mellitus & pre-gestational diabetes mellitus
4. The student should list the investigations done to screen (GCT), diagnose
(MGTT) and follow-up (BSP) patients with gestational diabetes mellitus & pregestational diabetes mellitus
5. The student should be able to use the different types of insulin and diet therapy to
treat patients with gestational diabetes mellitus & pre-gestational diabetes mellitus
6. The student should review the indications for termination of pregnancy in
gestational diabetes mellitus & pre-gestational diabetes mellitus
Practical skills
1. The student should be able to detect gestational diabetes mellitus & pregestational diabetes mellitus during the antenatal period by clinical evaluation and
by doing relevant investigations.
2. The student should be able to treat gestational diabetes mellitus & pre-gestational
diabetes mellitus
3. The student must be able to counsel women with gestational diabetes mellitus &
pre-gestational diabetes mellitus regarding potential complications to the mother
& fetus & timing of delivery
4. The student must be able to detect and manage gestational diabetes mellitus &
pre-gestational diabetes mellitus during labour
178
5. The student should be able to use the different preparations of oral and parenteral
iron therapy, indications for using different preparations of iron, dosage and
common side effects of iron therapy.
6. The student should review the indications for blood transfusion in pregnancy
Practical skills
1. The student should be able to detect anemia during the antenatal period by clinical
evaluation and by doing relevant investigations.
2. The student should be able to treat the common type of anemia in pregnancy like
nutritional anemia (mainly iron deficiency)
3. The student must be able to counsel and treat patients with Thalassemia (minor)
4. The student must be able to detect and manage anemia during labour
Lecture 25: Antepartum hemorrhage
Expected goal
The student should be able to recognize and manage a patient with antepartum
hemorrhage
Theoretical knowledge
1. The student should describe the common causes of antepartum hemorrhage
(placenta previa & abruptio placenta)
2. The student should recall the definition and common causes of antepartum
hemorrhage
3. The student should explain the maternal and fetal effects of placenta previa &
abruptio placenta
4. The student should list the investigations done to know the detect the cause of
antepartum hemorrhage, type of placenta previa and grade of abruptio placenta
5. The student should review the indications for conservative management &
termination of pregnancy of placenta previa
6. The student should list the indications for LSCS (emergency & elective) for
different causes of antepartum hemorrhage
Practical skills
1. The student should be able to detect different causes of antepartum hemorrhage in
the antenatal period by clinical evaluation and by doing relevant investigations.
2. The student should be able to counsel women with placenta previa & abruptio and
to treat them (basic management only, especially in an emergency)
3. The student must be able to detect and manage antepartum hemorrhage during
labour
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180
4. The student must be able to discuss the mangement of a lady with multifetal
pregnancy in labour
Practical skills
1. The student should be able to detect multifetal pregnancy by clinical evaluation
and by doing relevant investigations (e.g. USG).
2. The student should be able to recognize common complications of multifetal
pregnancy during pregnancy & in labour (both mother & fetus)
3. The student should be able to interpret common modalities of antepartum fetal
monitoring used for fetal evaluation
4. The student must be able to counsel women with multifetal pregnancy and
manage women during the antepartum & intrapartum period
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182
5. The student should know how to investigate a pregnant lady with Rh negative
blood group and to treat Rh isoimmunization.
Practical skills
1. The student should be able to detect Rh isoimmunization by clinical evaluation
and by doing relevant investigations.
2. The student should be able to counsel a pregnant lady with Rh negative blood
group and to prevent Rh isoimmunization.
183
1. The student must know how to determine the EDD accurately clinically as well as
by investigations like ultrasound
2. The student must have a knowledge of the maternal and fetal complications due to
prolonged pregnancy
3. The student must know about the various methods of induction of labour
Practical skills
1. The student must be able to determine the accurate period of gestation
2. The student must know how to monitor a patient with prolonged pregnancy and
decide when to terminate the pregnancy
3. The student must know how to counsel a patient regarding the maternal and fetal
risks after the EDD.
Lecture 31: Normal labor and partogram
Expected goal
1. The student must be able to diagnose and manage a lady in labour.
2. The student must be able to chart a partogram and recognize the deviations of
normal labour.
Theoretical knowledge
1. The student
2. The student
labour
3. The student
labour
4. The student
descriptors
5. The student
Practical skills
1. The student must be able to interpret routine data collected in labour
2. The student must be able to chart a partogram and define normal and abnormal
progress of labour
3. The student must able to conduct normal labour
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185
1. The student must be able to use common oxytocics like oxytocin, methylergometrine and prostaglandins in labour room.
2. The student must be able to counsel patients regarding the indications, merits and
complications of using oxytocics in obstetrics.
3. The student must know how to titrate oxytocin infusion for dysfunctional labour
and for atonic postpartum hemorrhage.
186
5. The student must know regarding the options for delivery in different
malpresentations
Practical skills
1. The student must be able to diagnose malpresentations by abdominal and vaginal
examination
2. The student must be able to identify complications of malpresentations when in
labour.
3. The student must be able to counsel patients regarding different options for mode
of delivery during pregnancy and when in labour.
4. The student must be able to diagnose cord prolapse by clinical examination and
initiate primary management for a patient with cord prolapse in labour
187
Expected goal
The student must be able to recognize different types of third stage complications, be able
to initiate primary management and co-ordinate multi-disciplinary-based plan of
management of the same.
Theoretical knowledge
1. The student must be able to describe causes of third stage complications & their
clinical features
2. The student must be able to name the complications of retained placenta,
morbidly adherent placenta, inversion of uterus etc
3. The student must be able to describe the management options women with
retained placenta, morbidly adherent placenta, inversion of uterus
Practical skills
1. The student should be able to formulate plan of management for women with
retained placenta, morbidly adherent placenta, inversion of uterus
2. The student must be able to counsel women with retained placenta, morbidly
adherent placenta, inversion of uterus (in emergency situations)
Practical skills
188
1. The student should be able to detect fibroid by clinical evaluation and by doing
relevant investigations
2. The student should be able to counsel patients regarding different options
available for treatment of fibroid medical & surgical
3. The student should be able to suggest treatment based on patients age, symptoms
and desire for fertility
Lecture 39: Endometriosis/Adenomyosis
Expected goal
The student should be able to clinically detect and suggest common modalities of
treatment for endometriosis and adenomyosis
Theoretical knowledge
1. The student must understand the pathogenesis and clinical presentation of
endometriosis
2. The student must be able to list the common investigations & principal medical
therapies used in endometriosis
3. The student must be able to reason the underlying principles of medical and
surgical management
Practical skills
1. The student should be able to detect endometriosis by clinical evaluation and by
interpreting relevant investigations
2. The student should be able to counsel patients regarding different options
available for treatment of endometriosis medical & surgical
3. The student should be able to suggest treatment based on patients age, symptoms
and desire for fertility
189
2. The student must be able to list the common investigations & principal medical
therapies used in dysfunctional uterine bleeding
3. The student must be able to reason the underlying principles of medical and
surgical management in dysfunctional uterine bleeding
Practical skills
1. The student should be able to detect dysfunctional uterine bleeding by clinical
evaluation and by interpreting relevant investigations
2. The student should be able to counsel patients regarding different options
available for treatment of dysfunctional uterine bleeding medical & surgical
3. The student should be able to suggest treatment based on patients age and
symptoms
Lecture 41: PCOS and Hirsutism
Expected goal
The student should be able to clinically detect and suggest common modalities of
treatment for polycystic ovarian disease
Theoretical knowledge
1. The student must understand the pathogenesis and clinical presentation of
polycystic ovarian disease
2. The student must be able to list the common investigations (biochemical,
sonological) & principal medical therapies (e.g. clomiphene citrate) used in
polycystic ovarian disease
3. The student must be able to reason the underlying principles of medical and
surgical management (ovarian drilling) in polycystic ovarian disease
Practical skills
1. The student should be able to detect polycystic ovarian disease by clinical
evaluation and by interpreting relevant investigations
2. The student should be able to counsel patients regarding different options
available for treatment of polycystic ovarian disease medical & surgical
3. The student should be able to suggest treatment based on patients age, symptoms
and desire for child-bearing
Lecture 42: Infertility/HSG
Expected goal
190
The student should be able to clinically detect and suggest common modalities of
treatment for common causes of infertility
Theoretical knowledge
1. The student must explain the physiology of normal conception and causes of male
& female subfertility
2. The student must be able to list the common investigations done to determine the
causes of male & female subfertility
3. The student must be able to discuss the management options for common causes
of male & female subfertility
Practical skills
1. The student should be able to evaluate a couple with subfertility by history,
clinical examination and by interpreting relevant investigations
2. The student should be able to counsel patients regarding different options
available for treatment of male & female subfertility along with their success rates
3. The student should be able to suggest treatment based on the etiology responsible
for subfertility
Lecture 43: Genital prolapse
Expected goal
The student should be able to clinically detect and suggest common modalities of
treatment for genital prolapse
Theoretical knowledge
1. The student must explain
supports of uterus) in the
2. The student must be able
3. The student must be able
in different age groups
Practical skills
1. The student should be able to evaluate a lady with genital prolapse by history and
clinical examination
2. The student should be able to counsel patients regarding different options
(conservative and surgical) available for treatment of genital prolapse in different
age groups
Lecture 44: Primary and secondary amenorrhoea
191
Expected goal
The student should be able to clinically recognize and formulate a plan to determine the
cause of primary & secondary amenorrhoea
Theoretical knowledge
1. The student must define primary & secondary amenorrhoea and name the clinical
features
2. The student must be able to discuss the etiology of primary & secondary
amenorrhoea (with emphasis on genetic, endocrine and anatomical basis)
3. The student must be able to discuss the management options for primary &
secondary amenorrhoea
Practical skills
1. The student should be able to evaluate a lady with primary & secondary
amenorrhoea by history and clinical examination & by relevant investigations
2. The student should be able to counsel patients regarding different options
available for treatment of primary & secondary amenorrhoea
Lecture 45: Urinary problems UTI, Stress, retention etc
Expected goal
The student should be able to clinically recognize common causes for urinary problems
in women & formulate a plan to determine the cause of the same
Theoretical knowledge
1. The student must explain the relevance of specific urinary symptoms in
gynecology
2. The student must be able to discuss the etiology & clinical presentation of
common causes for urinary tract infection, urinary incontinence and urinary
retention
3. The student must be able to discuss the management options and underlying
priniciples of threatment (surgical & non-surgical) of common causes for urinary
tract infection, urinary incontinence and urinary retention
Practical skills
1. The student should be able to evaluate a lady with urinary tract infection, urinary
incontinence and urinary retention by history and clinical examination & by
relevant urogynecological investigations
192
193
Practical skills
1. The student should be able to detect cervical cancer by clinical evaluation and by
interpreting relevant investigations
2. The student should be able to perform Pap smear and interpret the Bethesda
classification of the same.
3. The student should be able to counsel patients regarding available treatment of
cervical cancer
4. The student should be able to break bad news, suggest prognosis, follow-up and
appropriate treatment (radical hysterectomy/ chemo-radiotherapy) based on
patients age and staging of cervical cancer
Lecture 48: Carcinoma endometrium
Expected goal
The student should be able to clinically suspect and suggest common screening
modalities and treatment for endometrial cancer
Theoretical knowledge
1. The student must be able to list the risk factors, comprehend epidemiology,
describe pathogenesis and clinical presentation of endometrial cancer
2. The student must have the knowledge of staging of endometrial cancer
3. The student must be able to list the common investigations & modes of delivery
of radiotherapy (vault irradiation, whole abdominal radiation etc) used in
endometrial cancer
4. The student must be able to reason the underlying principles of surgical
management and chemo-radiation of early, advanced and recurrent disease
Practical skills
1. The student should be able to detect endometrial cancer by clinical evaluation and
by interpreting relevant investigations
2. The student should be able to counsel patients regarding available treatment of
endometrial cancer
3. The student should be able to break bad news, suggest prognosis, follow-up and
appropriate treatment (surgery/ chemo-radiotherapy) based on patients age and
staging of endometrial cancer
194
Practical skills
1. The student should be able to detect ovarian tumors by clinical evaluation and by
interpreting relevant investigations (ultrasound and tumor markers)
2. The student must be able to competently diagnose an ovarian tumor presenting as
emergency
3. The student should be able to counsel patients regarding available treatment of
ovarian tumors
4. The student should be able to break bad news, suggest prognosis, follow-up and
appropriate treatment (primary surgery/ chemotherapy and neoadjuvant
chemotherapy / interval debulking surgery) based on patients age and staging of
ovarian tumors
195
1. The student must be able to define contraception & list the common temporary &
permanent methods of contraception
2. The student must be able to describe the risks, benefits &adverse effects of
common temporary & permanent methods of contraception
3. The student must be able to review & appraise all available methods based on
age, parity, desire for child-bearing etc
Practical skills
1. The student must be able to compare the need to use different methods of
temporary & permanent methods of contraception and counsel women regarding
the pros and cons of each method (cafeteria method)
2. The student must be able to plan a recognize adverse effects of various methods
of temporary & permanent methods of contraception & initiate basic management
196
Theoretical knowledge
1. The student must list the indications & complications of common obstetric
procedures like LSCS, instrumental delivery, external cephalic version,
episiotomy, ARM etc
2. The student must list the indications & complications of common gynecological
procedures like hysterectomy, D&C, ERPOC, Papsmear, Pipelle sampling etc
3. The student must be able to outline the technique of common procedures done in
O&G
4. The student must be describe the preoperative and postoperative workup of
different procedures
Practical skills
1. The student must be able to counsel and explain to patients regarding common
procedures done in O&G
2. The student must be able to discuss the preoperative and postoperative workup of
different procedures
Lecture 53: Ultrasound in O&G
Expected goal
The student must discuss the indications of ultrasound in O&G and be able to interpret
the basic sonological reports.
Theoretical knowledge
1. The student must list the indications of ultrasound in each trimester in Obstetrics.
2. The student must list the indications of ultrasound in gynecology
3. The student must be able to recall the abnormalities detected on ultrasound in
O&G
Practical skills
3. The student must be able to interpret the sonological reports of common
conditions in O&G
4. The student must be able to counsel patients based on the sonological reports of
common conditions in O&G
5. The student must be able to formulate a plan of further management based on the
sonological report.
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198
7.record the information obtained, correlate the information to list & prioritize
differential diagnosis.
Learning Outcome:
1.Perform general physical, abdominal examination, observe speculum & bimanual
examination so as to be able to narrate the procedures for these examinations.
2.Perform pap smear screening.
NORMAL ANTENATAL CASE
Learning Objective:
1.Recall the methods to confirm pregnancy.
2.Judge the importance of prepregnancy counselling in relevant cases.
3.Recall the objectives of antenatal care.
4.Demonstrate a thorough knowledge on the routine investigations performed, including
the role of USG in antenatal care.
5.List the recommended schedule for antenatal visits.
6.Demonstrate knowledge regarding routine iron prophylaxis, immunization and drugs
contraindicated.
7.Plan routine antenatal advice, regarding nutritional requirements and healthy lifestyle.
Learning Outcome:
1.demonstrate competency and confidence in performing general physical examination
(including breast &thyroid) and obstetric examination which will include measurement of
SFH and obstetric grips.
NORMAL POSTNATAL CASE
Learning Objective:
1.Relate the physiology of puerperium and know normal postnatal events.
2.Discuss physiology of lactation & involution.
3.List common postpartum complications
4.Compare the advantages of breast feeding & disadvantages of formula feeding.
5.Recall the recommended immunization schedule for the newborn.
Learning Outcome :
1.Demonstrate appropriate communication skill in advising the postnatal mother on the
importance of early ambulation, adequate fluid intake, perineal care & postnatal exercise.
2.Perform postnatal examination on the mother & appreciate the normal and abnormal
findings during puerperium.
3.Formulate contraception counselling and advice
199
2.Describe the incidence, etiopathogenesis, maternal (ante,intra & postpartum) & fetal
complications of common medical disorders like anemia, preeclampsia, GDM & heart
disease.
3.demonstrate knowledge on antenatal & intrapartum implications for other high risk
pregnancies like previous LSCS, IUGR, recurrent pregnancy loss, multiple pregnancies
& abnormal lie & presentation.
4.Demonstrate thorough knowledge on screening & diagnostic investigative procedures
which are used to either diagnose or to assess the severity of any of these high risk
pregnancies.
5. Evaluate how these disorders affect the outcome.
6.Evaluate concepts relating to antepartum fetal surveillance and application of the same
in these high risk pregnancies.
Learning Outcome :
1.Evaluate any of these conditions based on history & physical examination.
2.demonstrate appropriate communication skill on warning signs of adverse pregnancy
events.
POSTNATAL CASE WITH A COMPLICATION
Learning Objective :
1.List common postnatal complications.
2.Recall the definition & different etiologies for primary & secondary postpartum
haemorrhage.
3.Name different etiologies of postpartum collapse.
4.Recall the definition & common causes for puerperal pyrexia.
5.Relate the local practice & recommendation regarding thromboprophylaxis for
postnatal & post caesarian section patients.
6.Recall the incidence & etiology of various mood disorders during puerperium.
7.Identify common problems relating to breast feeding & offer appropriate advice and
support if required.
8.Demonstrate knowledge on concepts relating to immediate resuscitation & evaluation
of women with postpartum collapse & haemorrhage.
Learning Outcome :
Assess any of the above conditions based on history and examination findings.
VAGINAL DISCHARGE
Learning Objective :
1.Discuss etiology of trichomoniasis, candidiasis and bacterial vaginosis.
2.Compare & contrast the clinical manifestations of these three types of lower genital
infections.
3.List the investigations to be performed and state "amsel's criteria" for the diagnosis of
bacterial vaginosis.
4.Discuss differential diagnosis including leucorrhea, drainage of amniotic fluid & genital
malignancies.
5.Discuss management including pharmacotherapy, follow up and management of the
partner.
200
201
A CASE IN LABOUR
Learning Objective :
1.Identify labour based on history, abdominal & pervaginal examination.
2.Discuss the stages of labour.
3.Compare and contrast the labour patterns between a primi and a multigrvida.
4.Discuss mechanism of labour.
5.Discuss indications and methods for induction of labour.
6.Demonstrate knowledge on and interpret electronic fetal monitoring in labour.
7.List common methods of obstetric analgesia.
8.List indications & complications of instrumental delivery.
9.Discuss active management of third stage of labour and list third stage complications.
Learning Outcome :
1.Evaluate stages of labour based on history and physical findings.
2.Analyse electronic fetal monitoring tracing.
3.Construct partogram
ABORTIONS
Learning Objective :
1.List differential diagnosis for bleeding in first trimester.
2.Define & distinguish various types of spontaneous abortions.
3.Recall etiology & complications of septic abortion.
4.Identify various ways of clinical presentation of ectopic pregnancy.
5. Identify signs & symptoms of missed abortion.
6.Recall follow up protocol for molar pregnancy.
7.Recall etiology & evaluation of recurrent abortion.
8.List indications & methods of MTP
Learning Outcome :
1.Evaluate findings of a bimanual examination in a women with early pregnancy
bleeding
2.Appraise ultrasound findings of differrential diagnoses in early pregnancy bleeding.
3.Counsel woman with H/O recurrent abortion.
PAIN ABDOMEN
Learning Objective :
1.Define acute & chronic pelvic pain.
2.Describe causes for each.
3.Identify emergencies.
202
Recommended Reading
Basic Reading:
1)
Ten teachers: Obstetrics by S. Cambell and C Lees. 2000. 17th Ed. Arnold P
2)
Ten teachers : Gynecology by S.Campbell and A Monga.2000.17th Ed. Arnold P
3)
Obstetrics Illustrated: Hanretty P Kevin, 2003. 16th Ed. Churchill Livingston
4)
Gynecology Illustrated: David Mc Kay Heart, 5th Ed. 2000. Churchill Livingston
5)
Shaws textbook of gynecology: VG Padubidri & SN Daftary.1999. 12th Ed. CL
6)
Oxorn Foote Human Labor and Birth: Harry Oxorn. 2000. 5th Ed. McGraw Hill
7)
Essential Obstetrics: S. Arulkumaran et al. 2004. Jaypee Publishers
203
204
205
Counsel women with maternal, fetal risks, prenatal diagnosis, fetal risks, fetal
reduction and recurrence risks
INTRAUTERINE GROWTH RESTRICTION (IUGR)
Intended Learning outcome
The student should be able to
Take an appropriate history and conduct an examinatio n to assess fetal size
Perform and interpret USG in fetus with suspected growth disorder
Formulate, implement management plan including timing and mode of delivery
Liaise with anesthesiologist and neonatologist
Counsel women with maternal, fetal risks, long-term health implications and recurrence
risks
BOH/RECURRENT ABORTION
Intended Learning Outcome
At end of the session the student should be able to
Take an appropriate history and conduct an examination
Interpret USG in mother with suspected BOH/Recuurent abortion
Formulate, implement management plan including timing and mode of delivery
Liaise with anesthesiologist, neonatologist
Counsel women with maternal, fetal risks and recurrence risks
VAGINAL DISCHARGE
Intended Learning Outcome
At end of the session the student should be able to
Take an appropriate history and conduct an examination to assess a woman with vaginal
discharge
Formulate implement management plan.
Liase with microbiologists
Counsel a woman with antibiotic therapy
206
FIBROID UTERUS
Intended Learning Outcome
At the end of the session the student should be able to
Take an appropriate history and conduct an examination to assess a woman with fibroid
uterus
Formulate implement management plan.
Liase with pathologists
Counsel a woman with pregnancy risks, drug therapy and surgical treatment
ENDOMETRIOSIS/ADENOMYOSIS
Intended Learning Outcome
At the end of the session the student should be able to
Take an appropriate history and conduct an examination to assess a woman with
endometriosis/adenomyosis
Formulate implement management plan.
Liase with pathologists
Counsel a woman with risks, drug therapy and surgical treatment
PROLAPSE UTERUS
Intended Learning Outcome
At the end of the session the student should be able to
Take an appropriate history and conduct an examination to assess a woman with prolapse
uterus
Formulate implement management plan.
Liase with urologists
Counsel a woman with risks, pessary therapy and surgical treatment
CARCINOMA OF CERVIX
Intended Learning Outcome
At the end of the session the student should be able to
Take appropriate history, conduct examination and investigate properly
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208
OPD
Intended Learning Outcome
At the end of the session the student should be able to
Demonstrate the observation skill of relevant history taking and examination of patients.
Demonstrate the application of knowledge as observation skill in noninvasive and
invasive
procedures
WARD WORK
209
Demonstrate the applied anatomy knowledge of female pelvis and assess the pelvis in a
patient at term in systematic manner
Show and explain the different parts of fetal skull and be able to clinically ascertain the
different presenting parts and position of fetus while doing a vaginal examination
Demonstrate mechanism of labor in a Occipitoanterior, Occipitoposterior & Assisted
Breech delivery by step by step
REVIEW OF STATIC STATION EXHIBITS INCLUDING CONTRACEPTION,
INSTRUMENTS IN O&G, CTG, PARTOGRAM
The student should be able to identify the various exhibits and should able to demonstrate
clinical knowledge in them.
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EMERGENCY DRILL
General Learning Outcome
At the end of session the student be able to
Formulate implement document management plan for an obstetric emergency
Rapidly assess the severity of maternal/fetal distress and institute resuscitative measures
To liase with anesthesiologist, neonatologist, gynecologist
Counsel for maternal, fetal and recurrent risks
PPC
At the end of session the student should be able to
Rapidly assess maternal collapse and institute resuscitative measures
To work effectively as part as of a multidisciplinary team
Formulate, implement management plan in maternal collapse.
Formulate appropriate surgical intervention
To liase with anesthesitists, hematologists and neonatologist
To debrief family members with management options, maternal risks, recurrent risk
ECLAMPSIA
At the end of session the student should be able to
Quickly assess eclamptic mother and institute resuscitative measures
To work effectively as part as of a multidisciplinary team
Formulate, implement management plan including appropriate choice of delivery and
method of delivery
To manage antihypertensive, anticonvulsant therapy in proper manner
To liase with anesthesitists, hematologists and neonatologist
To debrief family members with management options, maternal risks, recurrent risk
CORD PROLAPSE
At the end of session the student should be able to
Rapidly assess fetal status and institute appropriate manoveuvres to prevent cord
compression
To work effectively as part as of a multidisciplinary team
Formulate, implement management plan
Formulate appropriate surgical intervention
To liase with anesthesitists, and neonatologist
To debrief family members with management options, fetal risks, recurrence risk
SHOULDER DYSTOCIA
At the end of session the student should be able to
Formulate, implement management plan for shoulder dystocia
Perform manoveuvres to achieve delivery in shoulder dystocia
To liase with anesthesitists, and neonatologist
To debrief family members with management options, fetal risks, recurrent risk
211
INSTRUMENTAL DELIVERY
At the end of session the student should be able to
Formulate, implement management plan for instrumental delivery
Perform maneuvers to achieve delivery by instrumental delivery
To liase with anesthesitists and neonatologist
To debrief family members with management options, fetal risks and recurrent risk
ACTIVE 3RD STAGE MANAGEMENT
At the end of session the student should be able to
Formulate, implement management plan for 3 rd stage of delivery
Perform technique to achieve delivery of placenta
To liase with staff
ARM
At the end of session the student should be able to
Formulate, implement management plan for ARM
To liase with anesthesiologist, neonatologist
SDL
General Intended Learning outcome:
At the end of the session the student should be able to
Demonstrate the application of SDL concept for a given clinical problem, Medicolegal
issues and Ethics
Able to select and critically appraise the scientific article for a choosen clinical scenario
Able to analyse clinical guideline and apply to choosen clinical scenerio
COMMON PROGRAMME
Intended Learning Outcome
At the end of the session the student should be able to
Demonstrate the knowledge of clinical, integrative, management, communicative,
professional skills and educational attitude.
METHOD OF ASSESSMENT
Formative: Case sheet write ups, Case Presentation Evaluation
Summative: Clinical assessment, MEQs, MCQs.
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213
Communicate the results of the ob-gyn and general medical interview by well-organized
written and oral reports .
Interact with the patient to gain her confidence and cooperation, and assure her comfort
and modesty .
Perform accurate examinations in a sensitive manner, including: breast examina tion,
abdominal examination, complete pelvic examination, and recto-vaginal examination
Use accurate medical terminology to describe the: normal female anatomy across the life
cycle, appearance of common pathology of the female urogenital tract and appearance of
common breast changes and disorders.
Perform an adequate Pap smear.
Obtain specimens to detect sexually transmitted infections.
Handle specimens properly to improve diagnostic accuracy.
Provide an explanation to the patient regarding the purpose of these tests.
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Describe the management of the following STIs: gonorrhea, Chlamydia, herpes simplex
virus, syphilis, human papillomavirus infection, human immunodeficiency virus (HIV)
infection, hepatitis B virus infection
Describe the signs and symptoms ,pathogenesis and management and long term effects
of salpingitis.
Describe the diagnosis and management of UTIs.
Describe the key components of pre-operative evaluation and planning, including
complete medical histories, the informed consent process and working with consultants.
Describe the common peri-operative prophylactic measures,
Including steps taken to reduce infection and deep venous thrombosis.
Describe the components of routine post-operative care.
List common post-operative complications.
Describe the evaluation methods of abnormal uterine bleeding.
Describe the evaluation and management of dysmenorrhea.
Perform an adequate Pap smear.
Describe the initial management of a patient with an abnormal Pap smear.
Counsel a woman with risk for ovarian cancer
Complete a comprehensive womens medical interview, including: menstrual history;
obstetric history; gynecologic history; contraceptive history; sexual history; including
sexual orientation and sexual function; family history and social history
Evaluation
1.Portfolio evaluation.
2.Clinical Evaluation: Prior to completion of the 2 weeks senior clerkship, students are
expected to acquire the following skills:
Ability to:
Perform a complete history and physical examination of the female (both pregnant and
nonpregnant) and generate a problem list and a differential diagnosis.
Synthesize the data obtained from the history and physical to arrive at a diagnosis and
management plan for patients presenting in the typical manner with the following
obstetrical/gynecologic conditions: menstrual irregularity, menopause, osteoporosis,
vaginitis, common sexually transmitted diseases, pelvic or abdominal pain, pelvic mass,
common GYN malignancies (cervix, endometrial, ovarian, breast), normal pregnancy,
abnormal pregnancy including ectopic pregnancy and abortion, bleeding in pregnancy,
preeclampsia, and diabetes in pregnancy.
Communicate about a new patient in both an oral presentation and a written note that
presents subjective and objective data in a succinct and organized manner and is followed
by a realistic assessment and plan.
Perform an uncomplicated vaginal delivery.
Perform the pap smear and interpret the resulting report.
Describe the components of basic prenatal care.
Describe the physiologic changes associated with pregnancy.
Prescribe various forms of contraception.
Practice evidence based medicine, utilizing biomedical information from electronic
databases and other resources.
Observe
215
REFERENCES
1) Ten teachers: Obstetrics by S. Cambell and C Lees. 2000. 17th Ed. Arnold P
2) Ten teachers: Gynecology by S.Campbell and A Monga.2000.17th Ed. Arnold P
3) Obstetrics Illustrated: Hanretty P Kevin, 2003. 16th Ed. Churchill Livingston
4) Gynecology Illustrated: David Mc Kay Heart, 5th Ed. 2000. Churchill Livingston,
5) Shaws textbook of Gynecology: VG Padubidri & SN Daftary.1999. 12th Ed. CL
6) Essential Obstetrics: S. Arulkumaran et al. 2004. Jaypee Publishers
7) Text Book of Gynecology: D.C.Dutta 2001. 3 rd edition New Central Book Agency
(P) Ltd
8) Text Book of Obstetrics: D.C.Dutta. 6 rd edition New Central Book Agency (P) Ltd
Reference Books
1) Williams Obstetrics: Cunningham et al. 2001. 21st Ed. McGraw Hill
2) Novaks Gynecology: J Berek.2002. 13th Ed. Lippincott Williams and Wilkins
216
Learning Outcomes
217
LECTURES IN PSYCHIATRY
(TOPICS, LEARNING OBJECTIVES AND OUTCOME)
Learning objectives for Semester Semester 6/7 from Batch 29)
1. Introduction to Psychiatry
Learning objective: The student will learn the definition of psychiatry, functions of
the mind, history of psychiatry, current practice of psychiatry and future of
psychiatry.
Learning outcome: The student will understand the definition of psychiatry, functions
of the mind, history of psychiatry, current practice of psychiatry and future of
psychiatry.
2. Classification of Mental Disorders
Learning objective: The student will learn the classification of mental disorders
according to the Diagnostic and Statistical Manual of the American Psychiatric
Association as well as the International
Classification of Diseases of the World Health Organisation.
Learning outcome: The student will understand the classification of mental disorders
according to the Diagnostic and Statistical Manual of the American Psychiatric
Association as well as the International
Classification of Diseases of the World Health Organisation.
3. Aetiology of Mental Disorders
Learning objective: The student will learn the various causes for mental disorders
(biological, psychological and social) as well as chronological factors (predisposing,
precipitating and perpetuating and protective) causing mental disorders in individuals.
Learning outcome: The student will understand the various causes for mental
disorders (biological, psychological and social) as well as chronological factors
(predisposing, precipitating and perpetuating and protective) causing mental disorders
in individuals.
4. Learning and Memory
Learning objective: The student will learn the various theories of learning and its
application in psychiatry (understanding and treatment of some mental disorders) as
well as types of memory, brain memory centers and memory disorders
218
Learning outcome: The student will understand the various theories of learning and
its application in psychiatry (understanding and treatment of some mental disorders)
as well as types of memory, brain memory centers and memory disorders.
5.
6.
7.
219
Neurocognitive Disorders:
Learning objective: The student will learn the meaning of organic mental disorders,
types of organic mental disorders (focal and generalized) and the causes, symptoms
and management of delirium, amnestic disorder and dementia.
Learning outcome: The student will understand the meaning of organic mental
disorders, types of organic mental disorders (focal and generalized) and the causes,
symptoms and management of delirium, amnestic disorder and dementia.
220
222
The student learns about Electroconvulsive therapy and the bio psychosocial aspects of
managing mental illness.
Learning Outcome:
The student understands various aspects of Psychological and pharmacological treatment
modalities that are usually used, in the treatment. The student learns the basic
psychological prinicples and rationale for the various psychological treatments, and the
pharmacological aspects of various drugs such as antipsychotics,
antidepressants,anxiolytics,mood stabilisers and their mechanism of action and specific
roles of each of these drugs, and their indications. The student gets to witness
electroconvulsive therapy being undertaken, during the clinical posting in psychiatry. The
different indications and contraindications for ECT also discussed. The student is to
understand the bio psychosocial method of managing a person with mental illness.
(Some lectures are one hour and some are two hours)
223
PSYCHIATRY
LEARNING OBJECTIVES FOR SEMESTER 6 & 7: CLINICAL TEACHING
CLINICAL
The medical student will be able to demonstrate the ability to:
a. Perform an independent competent patient interview which will explore all
aspects of patients history (identification data, chief complaints, history of
presenting illness, current psychosocial stressors, functional impairment due to
the illness, current medical and drug history, family history, personal history,
premorbid personality and past medical and psychiatric history.
b. Perform a complete mental status examination (general appearance and
behaviour, speech, mood, thought content, perceptual disturbances and cognitive
functions which includes performing mini mental status examination (MMSE)
c. Perform a complete physical examination (general and systemic)
MEDICAL KNOWLEDGE
The student will be able to:
a. Know the meaning and clinical importance of terms used in psychiatric
evaluation (psychopathology)
b. Know the diagnostic criteria for various psychiatric disorders and be able to elicit
these criteria clinically from the patient and obtain relevant data form family
members.
COMMUNICATION SKILLS
The student will be able to:
a.
b.
c.
d.
Express findings
Express findings
Be empathic and
Work effectively
PROFESSIONALISM
The student will be able to:
a. Demonstrate an understanding of the ethical values and codes of a member of the
medical profession when dealing with patients and families.
b. Exemplify personal and intellectual integrity
c. Recognize and adapt to cultural differences
d. Demonstrate respect for patients and colleagues in interactions
e. Demonstrate a sensitivity and awareness of the patients culture, age, gender,
socioeconomic status, sexual orientation, religion and spirituality, and disabilities.
224
f.
PSYCHIATRY
LEARNING OBJECTIVES FOR SEMESTER 8 & 9
CLINICAL
The medical student will be able to demonstrate the ability to:
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
225
From Batch 29 in Semester 8 & 9 the shift: The above components of Semester 6
(Batch 28) will come in the first 2 weeks of Semester 8 & 9.
First 2 weeks - Semester 6 component (in Semester 8 & 9)
Learning Objectives and Outcomes
The following objectives and learning outcomes are to be taught and achieved by the
end of this three weeks posting:
a. The student will be taught and the student must be able to develop the basic
skills and knowledge in communication techniques, interview techniques (history
taking) in psychiatry.
b. The student will be illustrated / demonstrated signs, symptoms; verbal, nonverbal communication (Mental Status Examination) and the student must be
knowledge to these Mental Status Examination findings.
c. The student will be taught to understand problems related to the signs and
symptoms and the student must be able to understand problems of the patient
and able to relate them to signs and symptoms (Psychiatric Psycho-Pathology
PPP).
d. The student will be taught on aspects of active listening and hearing and
emphasis on open-ended and closed ended questions and note taking. This, the
student must learn to listen (Active Hearing) of what the patient / informant says,
understand their problems, strength, weakness, use appropriately open-ended
and close-ended questions.
The second two weeks of semester 8&9
The Portfolio currently followed in Semester 9&10 will be adhered to.
Semester !0 (proposed shift)
Beginning with Batch 29 it is proposed to have a few changes as a shift in the
Curriculum and also in the Portfolio. The changes include introduction of Portfolio Based
Challenge, DOPS, MINI-CEX, and Reflections.
MEDICAL KNOWLEDGE
The student will be able to:
1.1
226
1.2
1.3
1.4
1.5
Know the diagnostic criteria for various psychiatric disorders and be able to
elicit these criteria clinically from the patient and obtain relevant data form
family members.
Display proficiency in using the various drugs used in psychiatry such as
antipsychotics, antidepressants, mood stabilizers and anti-anxiety with regards
to drug selection in particular clinical scenarios, dosage, mechanism of action,
side-effects, appropriate monitoring, duration of treatment and safety in
children and pregnancy.
Know the various types of psychotherapy used to treat psychiatric disorders.
Have a good knowledge about culture bound syndrome pertaining to
Malaysia, Law and Psychiatry, Psychiatric emergencies and Medical ethics
PROFESSIONALISM
The student will be able to:
1.1
1.2
1.3
1.4
1.5
1.6
227
228
Learning Outcomes
229
230
dialysis,
pleural
aspiration,
lumbar
puncture,
bone
marrow
231
Attitudes:
The student shall:
Have the understanding and respect for all patients with different religious,
cultural and social values.
Have the understanding of ethical standards acceptable to the profession.
Have the right attitude and commitment to deliver the best possible medical care
for his/her patients, deriving maximal benefit from the available resources.
Develop a caring attitude towards patients and their families, and function as a
compassionate physician.
Integration
232
Over all learning outcome: at the end of effective training student will
Recognize and diagnose common clinical disorders with special reference to the
rising trend of non-communicable diseases in the country.
Will be conversant with the modes of management of common ailments with a
sound knowledge of drug therapeutics.
Will be able to propose diagnostic and investigative procedures and acquire the
ability to interpret them.
Will have a sound knowledge of the immediate management of acute
emergencies.
Will have the knowledge needed to recognize and manage socially challenged
groups such as the elderly, and the disabled.
Will have the ability to regularly update their knowledge, retrieve current
developments in medicine and practice evidence-based medicine.
233
Learning Objectives
234
Cardiovascular System
Topic 2.
Learning Objectives
management.
235
Cardiovascular System
Topic 3.
Learning Objectives
236
Learning Objectives
237
Learning Objectives
238
Cardiovascular System
Topic 6.
Learning Objectives
239
Learning Objectives
240
management
Learning Objectives
241
Endocrinology
Topic 9.
Learning Objectives
242
Endocrinology
Topic 10.
Hypothyroidism
Learning Objectives
243
Endocrinology
Topic 11.
pituitary diseases
Learning Objectives
244
Endocrinology
Topic 12.
diseases
Learning Objectives
245
Learning Objectives
Theory classes 2
Topic: Endocrinology- Cushings syndrome,
Addisons & Phaeochromocytoma
Learning Objectives
246
Theory classes 3
Learning Objectives
247
Theory classes - 4
Topic: Dengue fever & Meliodosis
Learning Objectives
To describe the etiopathogenesis,
complications, diagnosis, management of
Dengue fever.
248
Theory classes 5
Learning Objectives
249
Theory classes 6
Topic: Introduction to rheumatology
clinical aspects
Learning Objectives
Theory classes 8
Topic: Gout
Clinical features of scleroderma
Learning Objectives
To describe the etiopathogenesis, clinical
250
Theory classes 9
Topic: Poisonings
Clinical features & management of Organo
phosphorus compound, Paraquat and
paracetmol poisoning
Learning Objectives
To discuss the principles of management
poisoning in brief and antidotes usage with
rationale for Organophosphorus Compound,
Paraquat & Paracetamol with succinct
knowledge of protean manifestations of each
poisoning
Theory classes 10
Topic: Envenomation & Environmental
disorders
Learning Objectives
To describe the clinical manifestations of
snake envenomation and systemic
complications.
To acquire the basic concepts of
environmental medicine, with brief
knowledge of heat stroke and malignant
hyperthermia
251
Theory classes 11
Learning Objectives
To describe the clinical manifestations of
anaemia in general and outline the clinical
approach for classification of anaemias
Theory classes 12
Topic: Classification & management of
Leukaemias Part I
Learning Objectives
To describe the clinical manifestations of
and classification of leukaemias
252
Theory classes 13
Topic: Classification & management of
lymphomas Part II
Learning Objectives
To describe the clinical manifestations of and
classification of lymphomas
Theory classes 14
Topic: Classification & management of
leukaemias and myeloproliferative disorders
Part II
Learning Objectives
253
Theory classes 15
Learning Objectives
To understand the clinical manifestations of
and classification of lymphomas
254
Theory classes 16
Topic: Paraproteinemias (multiple myeloma
clinical features & management) &
Thrombocytopenia [ITP- Management]
Learning Objectives
255
Theory classes 17
Topic: Blood and blood products; Blood
transfusion and bone marrow transplantation
and tem cell transplantation
Learning Objectives
Theory classes 18
Topic:
a. Genetics - Genes, Genetic disorders and
Genetic counseling
b. Obesity - Definition, etiology,
Learning Objectives
256
Theory classes 19
Topic: Etiology, clinical features & management Mode of delivery: Didactic Lecture with
of Acute Hepatitis
audiovisual aids
Learning Objectives
To describe the causes of acute liver disease,
clinical manifestations, complications,
initiate appropriate investigations and outline
a management plan for the important causes
of acute liver disease
257
Theory classes 20
Learning Objectives
Theory classes 21
Learning Objectives
258
Theory classes 22
Topic: GERD, Non-ulcer dyspepsia &
management of Peptic Ulcer disease
Learning Objectives
To describe the clinical manifestations,
diagnosis and treatment of GERD, NonUlcer dyspepsia, peptic ulcer disease and
outline the H.Pylori eradication therapy
Theory classes 23
Learning Objectives
259
Theory classes 24
Learning Objectives
Theory classes 25
Learning Objectives
260
Theory classes 26
Learning Objectives
Theory classes 27
Learning Objectives
261
Theory classes 28
Theory classes 29
Learning Objectives
262
Theory classes 30
Learning Objectives
To recall the knowledge of dermatomes and
myotomes.
To discuss the, etiology, clinical
manifestations, classifications &
management of peripheral neuropathy.
Theory classes 31
Learning Objectives
To be able to define glomerulonephritis and
list the criteria for nephrotic and nephritic
syndromes with complications
To be able to discuss the etiology,
pathogenesis and histopathology of
glomerulonephritis in adult patients
To be able to apply the laboratory data and
interpret the same
263
Theory classes 32
Learning Objectives
Theory classes 33
Learning Objectives
To be able describe the etiology and clinical
features of CRF
264
Theory classes 34
Learning Objectives
To discuss the etiology, clinical
manifestations of fluid & electrolyte
imbalance [especially hyperkalaemia,
hypokalaemia, hypercalcemia and
hyponatraemia] and their complications
265
Learning Objectives
266
Learning Objectives
267
Initially in the posting this may go according to the checklist in the standard format,
however by the end of posting the student should be able to summarize the data into a
short, relevant account without overlooking important points. History should run like a
story not as a checklist of questions in a questionnaire. The student should be trained to
know the difference between interrogation and conversation. Conversation style
incorporates the art of talking besides figuring out the relevant problem in patients own
words.
Respiratory system
Learning Objectives
268
Cardiovascular system
Learning Objectives
hypertension]
269
Cerebellar Disorders]
Cerebellar Disorders]
270
renal failure]
271
endocrinology
[Viz; diabetes mellitus with
complications, Thyroid disorders {hyper
thyroidism & hypo thyroidism}],
Cushings syndrome, Pituitary disorders
and obesity]
272
Haematology
Learning Objectives
To acquire the skills to elicit a complete
history for the common haematological
disorders
273
Infectious diseases
Learning Objectives
To acquire the skills to elicit a complete
history for the common and life threatening
prevalent infections and their acute and
chronic complications in the geography
274
Locomotor system
Learning Objectives
To acquire the skills to elicit a complete
history for the common Rheumatologic &
connective tissue disorders
275
Learning Objectives
276
Initially in the final year posting of six weeks history taking may go according to the
checklist in the standard format, however by the end of posting the student should be able
to summarize the data into a short, relevant account without overlooking important points
and the students compulsorily on a rotational basis present in summary rounds as they are
adept in the above mentioned areas and it should run like a story not as a checklist of
questions in a questionnaire. The student already being trained in fourth year to know the
difference between interrogation and conversation will enhance his communication skills
with clinical fluency. Conversation style incorporates the art of talking besides figuring
out the relevant problem in patients own words.
277
278
Cardiovascular system
Learning Objectives
279
280
281
282
283
284
285
Reference Books
1 Harrisons Principles of Internal Medicine 17th Edition
2.Textbook of Medicine, Souhami and Moxam
3 Clinical Problems in General Medicine and Surgery, Churchill Livingstone, 2nd Ed
4 Washington Manual of Medical Therapeutics 32nd Edition
5.Dale Dubins rapid interpretation of EKGs 6th Edition
6.Medical short cases for medical students Bob Ryder
L.N.Naik
For Professor Choo Beng Huat
HOD, Medicine
Malacca Manipal Medical College
CCU: Coronary Care Unit
PKK-Peringitt Clinic
286
Learning Objectives
287
Semester 6 & 7
Problem Based Learning
Topic: 1.ECG analysis and interpretation
Date: Once a week
During Clinical postings
Learning Objectives
2.00pm-3.30pm
Learning Objectives
288
289
Learning Objectives
2.00pm-5.00pm
290
Learning Objectives
291
Learning Objectives
292
PBL Session 2
Topic: Clinical Problems in Neurology,
Nephrology and Hematology
Learning Objectives
293
PBL Session 3
2.00pm-3.30pm
Learning Objectives
294
PBL Session 4
Learning Objectives
PBL Session 5
Learning Objectives
To be able recognize the clinical
presentations of edema and ascites, illustrate
the basic science knowledge i.e.
pathophysiology of edema and ascites
295
PBL Session 6
Learning Objectives
296
PBL Session 7
Topic: Prescription writing
Twice a week
2.00pm-3.30pm
Clinical postings
Learning Objectives
To be able recognize the clinical problem and Student will recognize the clinical
records the definitive diagnosis based on the
problem and records the definitive
case scenario handed out
diagnosis based on the case scenario
handed out
To be able to plan, formulate the treatment
Will plan, formulate the treatment with
with an ability to write out legible
an ability to write out legible prescription
prescription for common medical conditions
for common medical conditions seen in
seen in the hospital
the hospital
Lecturer: L.N.Naik
Twice a week
2.00pm-3.30pm
Clinical postings
Learning Objectives
297
e-Learning
Topic: eLearning use of available
resources including authentic internet
resources and online medical databases
Session
Learning Objectives
298
Goal: At the end of the effective two weeks training in the structured programme of
senior clerkship in the 10th semester student should be able to analyze history, examine
the patient systematically, and interpret the clinical signs with accuracy, enabling him or
her to postulate differential diagnoses, to come to a final clinical diagnosis and be able to
plan the appropriate management
Learning objectives:
During the two weeks session at department of medicine in the hospital, student should:
a. Apply the knowledge of pathophysiology and evaluation methodology
[History taking skills, clinical examination and appropriate clinical diagnosis] by
integrating the basic science knowledge and the clinical know-how] throughout the
duration of clerkship, where he/she will be allocated hospital beds
299
300
Procedure
Observe
Assist
Perform
12.To educate the patients and the family and community in large for holistic approach
for individual health and prevention of diseases in the society by participating the patient
counseling held at bedside during ward work
e. Learning/Teaching activities: Most of the clerkship period is self-learning, highly
interactive with self- motivation and enthusiasm towards achieving an all round training
in different areas of Internal Medicine
f. Assessments: All the learning activities in the hospital which are documented in the
senior clerkship diary with various components of procedural skills under supervision,
patient data, follow up, discussions and compulsory long case clerking and laboratory
data [biochemical, histopathology, haematological, serology & other microbiological
investigations] interpretation inclusive of Radiological data, Arterial blood gases and
ECG as relevant to the acute and chronic ailments in the ward
Along with the daily evaluation student will be given a grade and score based on the
performance
Portfolios will be evaluated and students are encouraged to do reflective writing and
narrative article on their encounter with one patient, which enables him/her to
communicate well with the patient
Over all learning outcome of senior clerkship in medicine:
At the end of successful completion of two weeks clerkship in the department of
medicine student will apply the knowledge of pathophysiology and evaluation
methodology [History taking skills, clinical examination and appropriate clinical
301
diagnosis] by integrating the basic science knowledge and the clinical know-how]
throughout the duration of clerkship, where he/she will be allocated hospital beds
Will be able to clerk patients independently as part of shadow housemanship in the more
practical format utilizing the skills and knowledge acquired throughout the course, which
enables them to write progress notes
Will be able to make clinical decisions, which are apt to different real life case scenarios
in the wards
Will make a beginning for acquisition of the skills and ability to perform under
supervision by:
1. Gathering, interpreting and weighing the relevant data and organizing hierarchically
and document the clinical problems encountered in real patients during their two weeks
of clerkship at the hospital wards
2. Effective communication and conduct of an interview responsibly with the patient and
the relatives, always acknowledging the their cultural background, adhering strictly to the
patient confidentiality in the milieu of general wards at the hospitals
3. Respecting the patients wishes at all contexts or clinical encounters especially with the
terminally ill
5. Working in a team with interactions and communication with peers and the ward
doctors [Medical officers and housemen posted in medicine department]
6. Acquiring presentation skills of ward patients and discussions independently during
ward rounds
7.Interpreting the laboratory data [biochemical, histopathology, haematological, serology
& other microbiological investigations] interpretation [inclusive of Radiological data,
Arterial blood gases and ECG as relevant to the acute and chronic ailments in the ward]
of the patients allocated with clinical reasoning
302
9. Identifying the common emergencies and participate in the care of critically ill patients
and in resuscitations of patients in emergencies arising in the ward
10. Following-up of the patients and noting down the progress of illness or recovery and
document the same
303
Reference books:
Additional references
304
Learning Outcomes
305
306
307
308
Lecture 9: Lens: applied anatomy and physiology, classification clinical features and types
No
Venue
ITEM
OUTLINE
1)
Lecture OUTCOME
A) To study the normal anatomy and physiology and how
theatre
the alterations cause cataract
/college
B) To be able to recognize cataract as the most leading
cause of preventable blindness
C) To be able to diagnose, the different types of cataract
depending on the various symptoms and signs
Lecture 10: Lens: investigations, counselling and treatment of cataract surgery, complications
No
Venue
ITEM
OUTLINE
1)
Lecture OUTCOME
A) To study the various aspects of investigations of
theatre
cataract
/college
B) TO study how to counsel the patient regarding the care
to be taken before and after the cataract surgery
C) To be able to give the visual prognosis
D). To familiarize about the various techniques of cataract
operation
E) To be able to recognize the various complications of
cataract surgery and their treatment
309
310
311
312
Lecture 20: Optic nerve: papilloedema and inflammations of the optic neve
No
Venue
ITEM
OUTLINE
1)
Lecture OUTCOME
A) To study the various aspects of the optic nerve diseases
theatre
B) To recognize the importance of papilloedema and its
/college
different causes
C) TO be able to use this knowledge in the clinical
examination at a later stage
D) To study the various types of inflammations affecting
the optic nerve and their importance of recognition
E) To study the various investigative techniques and
treatment aavailable for the various conditions
Lecture 22: -Applied anatomy, symptomatic disturbances of vision, abnormalities of pupil, Light
reflex pathway and visual field pathway
No
Venue
ITEM
OUTLINE
1
Lecture
OUTCOME A) To study the applied anatomy of optic nerve, light
theatre/medical
reflex pathway and visual pathway.
college
B) To study the various signs and symptoms associated
with optic nerve diseases
C) To study the various abnormalities of pupil,light reflax
and visual pathways
D) To study the various investigations available to
diagnose and differentiate the conditions responsible for
these abnormalities
313
314
315
OUTLINE
A) Discuss about the lectures in general
B) Orientation about the sessional examination
2)
RECOMMENDED BOOKS
REFERENCE
TEXT BOOKS
1) Parsons diseases of the eye
2) Ophthalmology- A. K. Khurana
3) Essentials of ophthalmology By Samar. K. Basak
ADDITIONAL REFERENCES
1) Manual of ocular diagnosis and therapy by Deborah
Pavan Langston
2) Clinical ophthalmology- by Jack.J.Kanski
3) Anatomy and physiology of the eye-by A. K. Khurana
316
Integration of the national programme for control of blindness with the other national
health programmes.
Eye bank organization.
SKILLS
At the end of the course, the student shall be able to:
Elicit a history pertinent to general health and ocular status.
Assist in diagnosis procedures such as visual acuity testing, examination of the eye,
tonometry, staining for corneal ulcer, confrontation perimetry, direct ophthalmoscopy and
Cover test.
Diagnose and treat common problems affecting the eye.
Interpret ophthalmic signs in relation to common systemic disorders.
Provide first aid in major ophthalmic emergencies.
317
Assist to organize primary eye care service through primary health centers;
Attitudes
Have understanding and respect for all patients with different religious, and cultural and
social values.
Develop a caring attitude towards patients and their families and function as
compassionate doctor.
Have understanding of medical ethics
318
319
ATTITUDE
Have the right attitude and commitment to deliver the best possible care for his/her
Maintain confidentiality in the conduct of clinical examination and documentation of
diagnosis of patients.
Uphold the principles of ethics
Develop a caring attitude towards the patients and their families and function as a
compassionate physician.
COMMUNICATION AND INTEGRATION
Shall be able to communicate freely and effectively with individuals, groups and the
society as a whole in educating them and helping them in prevention of blindness
shall be able to integrate with the various national programmes of prevention of
blindness
320
321
Learning Outcomes
322
1. Learning objectives:
Over all objectives of Clerkship:
a. Understand concept of Emergency Department
b. Understand initial evaluation of the undifferentiated Emergency Medicine patient, and
stabilization of acutely ill patients, functioning as part of Emergency Department team.
c. Acquire knowledge of skills to approach traumatic injuries with priority to life
threatening problems, but also to common, less acute injuries, by observation and
participation in resuscitation activities
d. Understand structure and functions of A&E [Triaging and the level of emergency].
e. Understand the management of patients with toxic exposures in general, along with
specific, common overdoses, infectious, notifiable diseases.
f. Sharpen procedure skills, by constant practice
Learning outcomes: at the end of clinical rotation at A&E student will
a. demonstrate the understanding of basic concepts of Emergency Department
b. demonstrate the knowledge of initial evaluation of the undifferentiated Emergency
Medicine patient, and stabilization of acutely ill patients, functioning as part of
Emergency Department team.
c. demonstrate the knowledge of skills to approach traumatic injuries with priority to life
threatening problems, but also to common, less acute injuries, by observation and
participation in resuscitation activities
d. demonstrate the understanding of structure and functions of A&E [Triaging and the
level of emergency].
e. demonstrates the knowledge of management of patients with toxic exposures in
general, along with specific, common overdoses, infectious, notifiable diseases.
f. demonstrates a continual ability to sharpen the procedure skills, by constant practice
under supervision of the allowed clinical procedures
323
Developing Skills:
During the three weeks session at department of Emergency medicine in the hospital,
student will develop skills in the following competencies:
1. Information Management
a. Student demonstrates skill in case presentation.
b. Student demonstrates organized, complete written documents.
c Student demonstrates knowledge of accessing data and information systems.
d. Student treats each record as confidential and handles well, realizing the medico
legality of the documents
2. Diagnostic
a. Student will demonstrate a rapid, focused but thorough history and physical
examination.
b. Student will demonstrate appropriate usage and interpretation of laboratory and
ancillary tests by applying the knowledge of pathophysiology and evaluation
methodology
[History taking skills, clinical examination and appropriate clinical diagnosis] by
integrating the basic science knowledge and the clinical know-how]
3. Procedural
In the A&E setting student is under direct supervision of the seniors and follow a general
dictum for all procedural skills with a clear instruction list indicating the procedures
allowed to be performed by the student
Procedure
Observe
Assist
Perform
324
All students MUST follow Universal Precautions at all times in the A&E department
4. Professional Behaviour
Student will demonstrate ability to function as part of health care team, showing respect
for patients, staff, and physicians.
Student will demonstrate understanding of patient right to treatment, refusal of treatment,
and when care needs to be performed against a patients will.
Professional working attire is a must to follow the dress code at all times inclusive of
duty days on public holidays
5. Problem solving
a.Student will demonstrate list of differential diagnoses given a specific chief complaint
and patient characteristics.
b.Student will demonstrate ability to use history, physical exam and ancillary studies to
test initial diagnoses.
c.Student will demonstrate the ability to rerank the differential diagnoses based on
gathered information.
5.Human Relationships and Communications :
Student will demonstrate ability of
a. inquiry about family and support systems, understanding of cultural diversity in health
care delivery
b. understanding social, psychological, and economic factors in health care delivery
c. effectively engaging patient and family in verbal communication.
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Summary:
Patient Care:
Develop proper interviewing techniques
Perform directed physical examinations
Develop comprehensive differential diagnoses
Initiate resuscitation and stabilization
Selected procedural and wound care techniques
Proper patient disposition and follow-up
Medical Knowledge
Identification of the acutely ill patient
Practice evidence-based medicine
Development an evaluation plan
Test interpretation
Development of a therapeutic plan
Treatment of common acute problems
Interpersonal and Communication Skills
Establishing rapport
Effective presentation
Professional interaction with consultants
Professionalism
Respect
Ethical behavior
Sensitivity to cultural issues
Compliance to regulations
Systems-based Practice
Understanding of emergency procedures
Assessment of undifferentiated patient
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Learning Outcomes
327
Objectives
Outcomes
Understand the
Knowledge
discipline of patient
safety and
its role in
minimizing the
incidence and
impact
of adverse events,
and maximizes
recovery
from them.
Skills
2.What is
human
factors and
why is it
important to
patient
safety?
(Human
factor in
Patient
safety)
3.Understan
ding systems
and the
impact of
complexity
on patient
care
(Understandi
ng hospital
functioning
about
patient care)
Understand human
factors and its
relationship to
patient safety.
Knowledge
Skill
Understand how
systems thinking
can
improve health
care and minimize
patient adverse
events.
Year 1
the harm caused by
health-care errors and
system failures
the lessons about
error and system failure
from other industries
the history of patient
safety and the origins of
the blame culture
the difference
between system
failures, violations and
errors
a model of patient
safety
apply patient safety
thinking in all clinical
activities;
demonstrate ability to
recognize the role of
patient safety in safe
health-care delivery.
explain the meaning
of the term
human factors;
explain the
relationship between
human factors and
patient safety.
apply human factors
thinking to your
work environment.
Year2
Year3
**
**
**
**
Knowledge
Skill
**
328
Year4
understand the
Knowledge
importance of
teamwork in
health-care;
know how to be
an effective team
player;
recognize you will
be a member of a
Skill
number of healthcare teams as a
medical students.
5.Understan
ding and
learning
from errors
Understand the
nature of error and
how
health care can
learn from error to
improve patient
safety
Knowledge
6.Understan
ding and
managing
clinical risk
Knowledge
**
**
Skill
Skill
**
**
**
329
7.Introductio
n to quality
improvemen
t methods
describe the
Knowledge
principles of quality
improvement and
to introduce
students to the
basic methods and
tools for
improving the
quality of health
care.
Skill
8.Engaging
with patients
and carers
The objective of
this topic is to
understand
the ways in which
patients and carers
can be
involved as
partners in health
care, both in
preventing harm
and learning and
healing from an
adverse event
Knowledge
Skill
supervisor, senior
clinician and other
health-care
professionals
patient safety;
participate in
meetings that discuss
risk
management and
patient safety;
respond appropriately
to patients and families
after an adverse event;
respond appropriately
to complaints.
the science of
improvement;
the quality
improvement model;
change concepts;
two examples of
continuous
improvement
methods;
methods for providing
information on
clinical care.
know how to perform
a range of
improvement activities
and tools
Students need to know:
basic communication
techniques;
informed consent
procedures;
the basics of open
disclosure.
Students need to:
actively encourage
patients and carers to
share
information;
show empathy,
honesty and respect for
patients and carers;
communicate
effectively;
**
**
**
**
330
9.Minimizing
infection
through
improved
infection
control
Demonstrate
the devastating
effects of
inadequate
infection
control and to
show students
know they can
minimize the risks
of contamination
Knowledge
obtain informed
consent;
show respect for each
patients differences,
religious and cultural
beliefs, and individual
needs;
describe and
understand the basic
steps in an
open disclosure
process;
apply patient
engagement thinking in
all clinical
activities;
demonstrate ability to
recognize the place of
patient and carer
engagement in good
clinical
management
know the extent of
the problem;
know the main causes
and types of
infections.
**
Skill
apply universal
precautions;
be immunized against
Hepatitis B;
use personal
protection methods;
know what to do if
exposed;
encourage others to
use universal
Precautions
**
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11.Improving
medication
safety
understand
Knowledge
the main causes of
adverse events in
surgical and
invasive procedural
care and how the
use of
guidelines and
verification
processes can
Skill
facilitate
the correct patient
receiving the
correct procedure
at the appropriate
time and place.
objectives:
to provide an
overview of
medication
safety;
to encourage
students to
continue to learn
and practise ways
to improve the
safety of
medication use
Knowledge
**
**
**
332
Skill
approach to medication
safety
clinician performs in the
following tasks:
use generic names;
tailor prescribing for
each patient;
learn and practise
thorough medication
history taking;
know the high-risk
medications;
be very familiar with
the medications you
prescribe;
use memory aids;
communicate clearly;
develop checking
habits;
encourage patients to
be actively involved in
the medication process;
report and learn from
errors;
learn and practise
drug calculations.
**
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